Interactive Case Studies - Overview

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Monitoring and Maintaining Bone Health in a Postmenopausal Patient With Stage II Breast Cancer Undergoing Adjuvant Endocrine Therapy

Release Date: February 19, 2009
Expiration Date: February 19, 2010

Interactive Case Study Overview

For postmenopausal patients with hormone receptor–positive, early-stage breast cancer, aromatase inhibitors (AIs) have substantially improved disease outcome, whether incorporated up front or using switching or sequencing strategies in this patient population. Bone loss occurs more rapidly following menopause, putting this population at increased risk of developing osteopenia or osteoporosis and experiencing fractures. Furthermore, compared to adjuvant tamoxifen therapy, AIs are associated with increased bone mineral density (BMD) loss and fracture rates. Regular monitoring of BMD and fracture risk along with intervention when necessary are critical for the maintenance of bone health, although the optimal strategies are currently under debate. This requires physicians to examine the therapeutic options for maintenance and restoration of bone health in patients with low BMD who are receiving endocrine therapy. Several bone-targeted agents, including bisphosphonates, are under investigation for the prevention of bone loss in the adjuvant setting, although the best timing and duration of therapy are still under investigation.

The purpose of this activity is to update physicians on the monitoring and maintenance of bone health in postmenopausal patients who are receiving adjuvant endocrine therapy for hormone receptor–positive, early-stage breast cancer.

Target Audience

This educational activity is intended for medical oncologists involved in the care of patients with breast cancer. No specific skills or knowledge other than a basic training in oncology is required for successful participation in this activity.

Learning Objectives

Upon completion of this educational activity, you should be able to:

  • Identify the risk factors for osteoporosis and bone fractures in patients with breast cancer
  • Examine the current recommendations for antiresorptive therapy in patients with breast cancer
  • Discuss the efficacy and safety of antiresorptive therapy, including bisphosphonates, in patients receiving endocrine therapy for early-stage breast cancer

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  1. Read the following information before entering the educational activity.
  2. Complete the Pretest.
  3. Study the educational activity.
  4. Complete the Posttest.
  5. Answer the evaluation questions.
  6. After completion of the Pretest and successful completion of the Posttest and evaluation, you will receive your certificate online.

Successful completion is determined by a score of 65% or greater.

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Allan Lipton, MD
Research Funding – Monogram Biosciences, Novartis Pharmaceuticals Corporation, Oncogene Science
Speaker’s Bureau – Amgen, GlaxoSmithKline, Novartis Pharmaceuticals Corporation
Other Remuneration – Novartis Pharmaceuticals Corporation

PER Editorial Staff
No relevant relationships to disclose

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Illustrator: Erin Moore

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Editor, Interactive Case Study, Monitoring and Maintaining Bone Health in a Postmenopausal Patient With Stage II Breast Cancer Undergoing Adjuvant Endocrine Therapy
Physicians’ Education Resource
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Educational Grants

An educational grant for this activity was provided by:


  1. Novartis Oncology

Allan Lipton, MD
Professor of Medicine and Oncology
Milton S. Hershey Medical Center
Hershey, PA