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Bone Health and Breast Cancer

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One of the last things you may think about when diagnosed with breast cancer is the health of your bones.

You probably already know the importance of keeping your bones healthy throughout your life, but it becomes especially important after a breast cancer diagnosis. Why? Certain treatments, such as chemotherapy, can cause significant bone loss or fractures. It’s possible for chemotherapy to cause early menopause, which would result in a loss of estrogen. It’s also possible to experience a dip in estrogen levels just from surgery as well. Estrogen protects the bone,  so if these levels become low, it can result in bone loss or a fracture.

Upon diagnosis, ask your healthcare team if you should have the health of your bones evaluated. One of the exams that may be recommended is called a DEXA scan. The word DEXA is an abbreviation for Dual Energy X-Ray Absorptiometry. This particular exam will typically measure your bone mineral density (BMD) between your spine and hip. The scan will calculate how much radiation your bones absorb from the exam and will then be compared to other young premenopausal women and other women in your age group. DEXA uses less radiation than a standard X-Ray or a CT (CAT) scan would.

The measurements taken will determine if you have osteopenia (thinning of bone mass) or osteoporosis (loss of bone mass). DEXA scans tell you how strong your bones are at the time of the test, and while unable to predict future bone loss or indicate previous bone loss, can indicate the chance of a fracture in the future. Your doctor will go over your test results with you and hopefully explain in detail what it all means.

These results will be scored into a T-score or a Z-score. A T-score is used to estimate your risk of breaking a bone and tells the difference between your bone density and the average bone density of young, healthy woman.  A score above -1 is considered normal. A score between -1 and -2.5 is classified as Osteopenia. A score below -2.5 is classified as osteoporosis.  A Z-score is the amount of bone you have compared to other women of your age and race.  Depending on the results of this test-either very high or very low-it’s possible that you may need further tests.

There are other tests out there that can also assist in determining bone health, but DEXA is the gold standard. DEXA scans are easy and should be painless. The exam should take approximately 30 minutes and involves lying on a table while a machine scans the body. It may also be recommended for you to have a blood/urine test called the bone marker test. This test can determine the likeliness of a future fracture and to monitor drug therapy that affects bone health as well.

If tests indicate that your bone health is at risk, your healthcare team may recommend that you have DEXA scans on a regular basis. Each result would be compared with the other to monitor your bone health. In addition, your doctor may prescribe a medication that can help preserve bone mass.

As confusing and scary as this all may seem, there are steps that you can take to protect your bones. Some of the steps are very basic, common sense type things. They are:

  • Taking calcium and vitamin D. Ask your doctor how much you should be taking each day.
  • Performing weight bearing exercises in 30 minute intervals at least 3 days a week.
  • Doing cardio exercise in 30 minute intervals at least 3 days a week.
  • Avoid smoking and excessive alcohol drinking.
  • Eating a balanced diet.
  • Build strong muscles and improve balance to prevent falling that could result in a bone fracture.

References: MyHealth, MyJourney: Courage for the Journey, Hope for the Future, www.spineuniverse.com, www.osteopenia3.com, www.breastcancer.org and www.labtestsonline.org

This article is intended to convey general educational information and should not be relied upon as a substitute for professional healthcare advice.

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