| Objective To observe the effects of different types of endocrine therapy on bone metabolism in advanced breast cancer patients.Methods A total of 239 cases breast cancer patients with endocrine treatment were collected from May 2013 to January 2019 in Southern Medical University Affiliated Xiaolan Hospital. According to endocrine therapy, all patients were divided into group A (tamoxifen, 83 cases), group B (fulvestrant, 75 cases) and group C (exemestane, 81 cases). The biochemical markers of bone metabolism, including calcitonin, osteocalcin, bone alkaline phosphatase and parathyroid hormone were detected before and after 12 months treatment. Lumbar vertebral bone density (BMP) was measured at the base and 12 months after treatment. Results Before treatment, the values of CT, BGP, BAP, PTH and BMP in three groups were compared, and the differences were not statistically significant (P>0.05). After treatment, CT value of the three groups increased in different degrees, group C had the largest increase range and group A had the smallest increase range, and the absolute value of difference between the groups was statistically significant (P=0.009). After treatment, BGP value of the three groups rose in different degrees, group A had the largest increase range and group B had the smallest increase range, and the absolute value of difference between the groups was statistically significant (P=0.005). After treatment, BAP value of the three groups decreased in different degrees, with the largest reduction in group B and the smallest in group A, and the absolute value of difference between the groups was statistically significant (P=0.018). After treatment, PTH value of the three groups decreased in different degrees, with the greatest reduction in group C and the smallest in group A, and the absolute value of difference between groups was statistically significant (P=0.025). After treatment, there was statistically significant difference in lumbar BMP value between the three groups (P=0.007). Among them, there was no significant decrease in lumbar bone density in group A, while the most significant decrease was detected in lumbar bone density in group C, and the absolute value of difference between the groups was statistically significant (P=0.022). Conclusions Endocrine therapy treatment for breast cancer may result in decreased bone density and increased incidence of bone adverse events, but tamoxifen has the least impact on bone metabolism. |
