Background: Osteoporosis is highly prevalent among Indian women and is further exacerbated by cancer-directed therapies such as chemotherapy, hormonal therapy, and radiotherapy. Patients with breast cancer are particularly susceptible to bone loss. While dual energy X-ray absorptiometry (DXA) remains the gold standard, it does not assess bone microarchitecture. High-resolution peripheral quantitative computed tomography (HR-pQCT) may provide additional insights.Methods: This cross-sectional pilot study was conducted between May and December 2024 at a tertiary care center and included 54 women with breast cancer without bone metastases. Demographic, clinical, and treatment data were recorded. All patients underwent DXA and HR-pQCT scans to assess bone density and microarchitecture. Statistical analysis included subgroup comparisons and concordance testing.Results: Mean age was 55.8±11 years, and 65% were postmenopausal. Estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 positivity rates were 76%, 57%, and 28%, respectively. Osteoporosis was found in 38.2% and osteopenia in 61.8% by DXA. HR-pQCT revealed lower volumetric bone density (0.59±0.07 g/cm³) compared to DXA (0.84±0.16 g/cm³, P<0.01). Microarchitectural deficits were significant in postmenopausal women, chemotherapy recipients, and those on letrozole. Lin’s concordance correlation indicated poor agreement between HR-pQCT and DXA (<0.9).Conclusions: HR-pQCT was superior to DXA in detecting microarchitectural deterioration in women with breast cancer. This pilot study emphasizes the need for larger prospective studies in Indian cohorts.
Kumari et al. (Sun,) studied this question.
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