ORIGINAL RESEARCH article
Front. Med.
Sec. Translational Medicine
Impact of Different Endocrine Therapies on Bone Mineral Density and Fracture Risk in Postmenopausal Breast Cancer Patients: A Meta-Analysis
Provisionally accepted
- 1The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
- 2Third Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
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Objective: To investigate the effects of different endocrine therapies (tamoxifen, aromatase inhibitors, selective estrogen receptor modulators) on bone mineral density (BMD) and fracture risk in postmenopausal breast cancer patients. Methods: A systematic search was conducted in PubMed, Medline, Web of Science, Cochrane Library, and EMBASE databases to identify randomized controlled trials (RCTs). The quality of RCTs was assessed using the Cochrane Risk of Bias Tool, Meta-analysis was performed using RevMan 5.3 software, with primary outcome measures including changes in BMD and fracture risk. Results: A total of five studies involving 20,531 patients were included. Meta-analysis results showed: Osteoporosis incidence: Pooled analysis of two studies yielded pooled odds ratio OR of 0.35 (95% CI: 0.04, 3.00), indicating a slight but non-significant advantage in reducing fracture risk in the experimental group compared to the control group (Z=0.96, P=0.34). This finding is based on only two studies, so there is uncertainty associated with it. Heterogeneity was low (I²=97%). fracture risk: The pooled OR from four studies was 1.40 (95% CI: 1.25, 1.57), demonstrating a statistically significant increase in fracture risk in the experimental group (Z=5.92, P<0.001) with low heterogeneity (I²=29%). Conclusion: The conclusions of this analysis were constrained by the limited number of available studies. Different endocrine therapies might exert varying effects on bone health. Aromatase inhibitors significantly reduce BMD and increase fracture risk, whereas selective estrogen receptor modulators might have a protective effect on bone. These relationships need confirmation in larger studies. Clinicians should consider bone health among other factors when selecting endocrine therapy.
Keywords: postmenopausal breast cancer, Endocrine therapy, bone mineral density, Fracture risk, Systematic review, Meta-analysis
Received: 14 Jul 2025; Accepted: 10 Nov 2025.
Copyright: © 2025 Qu, Wang, Wang, Guan and Zheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yuling Zheng, acq7861632@163.com
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