Background and Aim: Aromatase inhibitors (AIs) and selective estrogen receptor modulators (SERMs) are important components of adjuvant endocrine therapy in postmenopausal women with estrogen receptor positive breast cancer. The aim of our study was to assess the effect of AIs and SERMs on bone mineral density (BMD) in Caucasian postmenopausal women with breast cancer. Patients and Methods: 118 postmenopausal Caucasian women were enrolled in the study. 60 patients were receiving AIs and 58 patients -SERMs-Tamoxifen. Patients were also divided into two sub groups: 1) patients with more than 3 years of last menstrual period (LMP) and 2) patients with less than 3 years of last menstrual period. Results: Among Aromatase inhibitors treated patients, there was a decrease in median BMD from baseline to 5 years in lumbar spine and total hip compared with the Tamoxifen group. No patients with normal BMD at baseline became osteoporotic at 5 years. Conclusion: Aromatase inhibitors are associated with accelerated bone loss over the 5-year treatment period. In postmenopausal women, treatment with tamoxifen is associated with preservation of the bone mineral density of the lumbar spine

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Background: Osteoporosis, that denotes the bone porosity, is the disease, when the bone mineral density (BMD) is decreased. Bones become porous and fragile, that increase the risk of bone fractures. Bone mass loss develops slowly and progressively. Fractures often develop with no symptoms. According to the WHO criteria, osteoporosis is defined as a BMD that lies 2.5 standard deviations or more below the average value for young healthy women (a T-score of ≤ -2.5 SD). Bone cell elements are represented with osteoblasts, osteoclasts, osteocytes and lining cells of small quantity. Osteoblasts are the bone forming cells. Their major functions are the bone matrix synthesis and its following mineralisation. Vitamin D and calcium also participate in the process of mineralisation. Osteoclasts are the bone resorbtion cells. Their main function is the breakdown of old bone and its resorption by lysosomal enzymes. Osteocytes are formed from osteoblasts and promote the maintenance of bone matrix. These cells regulate the activity of modeling and remodeling processes. Osteoporosis represents the result of disbalance of breakdown and synthesis.

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