Adjuvant Aromatase Inhibitors in Early Breast Cancer May Not Increase the Risk of Falls

Abstract

Background Falling increases the risk for fracture. The impact of adjuvant aromatase inhibitors (AI) on the risk of falls is undefined. Methods A retrospective case control study was performed examining women with early stage breast cancer on adjuvant AI and matched controls without cancer. Fall and fracture data were abstracted from the medical record. Results Matched pairs of 332 women were identified (total N = 664). There was no statistically significant difference in the odds of a fall between cases and controls, p = 0.86. Similarly, the odds of a fracture between cases and controls was not significantly different, p = 1.0. There were 35 pairs in which the case fractured but the control did not and equal number of pairs where the control fractured but the case did not. For pairs in which control fractured but case did not, the median age at fracture was significant higher than that for pairs in which case fractured but the control did not (71 vs. 63 years p = 0.0003). Conclusion This study did not identify a difference in the incidence of falls or fractures in women on adjuvant AI compared to their age matched controls without breast cancer. Prospective studies of falls and fracture in women on adjuvant AI therapy compared to age match controls would aid in the identification of fracture risk.

Joint pain and falls among women with breast cancer on aromatase inhibitors

“…23,24 To our knowledge, the few studies that have investigated falls among women with breast cancer have been retrospective or have had small sample sizes, and no study has investigated arthralgia as a risk factor for falls. 27,28 The fall rate of one in three women we observed appears to be in the range reported by prior studies. A retrospective chart review study reported a 25% fall rate in a five-year period among women with breast cancer on AI therapy, 27 which was lower than the fall rate of 35% in a one-year period that we observed prospectively.…”

“…27,28 The fall rate of one in three women we observed appears to be in the range reported by prior studies. A retrospective chart review study reported a 25% fall rate in a five-year period among women with breast cancer on AI therapy, 27 which was lower than the fall rate of 35% in a one-year period that we observed prospectively. The discrepancy could be the result of limited inquiries about falls from physicians, which leads to less documentation of falls in medical records.…”