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Aromatase inhibitors and calcium absorption in early stage breast cancer

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Abstract

To investigate the effect of aromatase inhibitors (AI) on intestinal calcium absorption, measured using the gold-standard dual stable calcium isotope method. In this pilot study, we recruited 10 postmenopausal women with hormone receptor-positive breast cancer who planned to initiate AI therapy; women receiving chemotherapy were excluded. Women completed two 24 h inpatient calcium absorption study visits, the first prior to AI therapy and the second at least 6 weeks following onset of AI therapy. We calculated total fractional calcium absorption (TFCA) using the dose-corrected fractional recovery of two stable isotopes from 24 h urine collections. Ten postmenopausal women (mean ± SD age, 66 ± 7 years; 25(OH)D 40 ± 7 ng/mL, and total calcium intake of 1,714 ± 640 mg/day) exhibited no change in TFCA related to AI therapy (0.155 ± 0.042 prior to and 0.160 ± 0.064 following AI therapy, p = 1.0). Subjects exhibited a surprisingly small decline in serum estradiol levels with AI therapy that was not statistically significant. However, there was a significant correlation between duration of AI therapy and the decline in serum estradiol levels (r = −0.65, p = 0.040). In this pilot study, AI therapy did not decrease TFCA. Women with early stage breast cancer exhibited an unexpectedly low TFCA, most likely due to their high calcium intake. The null effect of AI therapy on TFCA might relate to the brief duration of AI therapy, the minimal effect of AI therapy on estradiol levels, subjects’ high calcium intake or excellent vitamin D status.

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Acknowledgments

We thank the participants, who made this research possible. We thank the University of Wisconsin Clinical Research Unit nursing staff for outstanding research assistance and patient care. KEH received salary support from the National Institute of Health (K23 AR050995 and R01 AG028739) during the conduct of this study. The project was supported by grants from the American College of Rheumatology/Research Education Foundation with the American Society for Specialty Physicians through the Hartford Foundation and Atlantic Philanthropies (Junior Career Development Award in Geriatric Medicine) and by grant UL1RR025011 from the Clinical and Translational Science Award (CTSA) Program of the National Center for Research Resources, National Institutes of Health.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. University of Wisconsin School of Medicine and Public Health, Room 4124, 1685 Highland Avenue, Madison, WI, 53705-2281, USA

    Amye Tevaarwerk, Mark E. Burkard, Kari B. Wisinski, Elizabeth Crone & Karen E. Hansen

  2. University of Wisconsin Carbone Cancer Center, WIMR 6037, 1111 Highland Ave., Madison, WI, 53705, USA

    Amye Tevaarwerk

  3. University of Wisconsin Carbone Cancer Center, WIMR 6059, 1111 Highland Ave., Madison, WI, 53705, USA

    Mark E. Burkard

  4. University of Wisconsin Carbone Cancer Center, WIMR 6033, 1111 Highland Ave., Madison, WI, 53705, USA

    Kari B. Wisinski

  5. Wisconsin State Lab of Hygiene, Madison, WI, USA

    Martin M. Shafer

  6. University of Wisconsin Institute for Clinical and Translational Clinical Research, Madison, WI, USA

    Lisa A. Davis

  7. Centegra Health System, Crystal Lake, IL, USA

    Jyothi Gogineni

Authors
  1. Amye Tevaarwerk
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  2. Mark E. Burkard
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  3. Kari B. Wisinski
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  4. Martin M. Shafer
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  5. Lisa A. Davis
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  6. Jyothi Gogineni
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  7. Elizabeth Crone
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  8. Karen E. Hansen
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Corresponding author

Correspondence to Karen E. Hansen.

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Tevaarwerk, A., Burkard, M.E., Wisinski, K.B. et al. Aromatase inhibitors and calcium absorption in early stage breast cancer. Breast Cancer Res Treat 134, 245–251 (2012). https://doi.org/10.1007/s10549-012-1982-z

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  • DOI: https://doi.org/10.1007/s10549-012-1982-z

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