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Osteoporosis and Breast Cancer Osteoporosis, the loss of bone mass and structure, is hastened by the sudden drop in estrogen levels that occurs as a woman enters menopause, either naturally, by surgical removal of the ovaries before age 45, or by premature menopause caused by breast cancer treatment. Estrogen protects the bones, so estrogen deficiency is a definite risk factor for osteoporosis. Women who have had breast cancer or are considered at high risk for developing breast cancer generally receive a recommendation not to take Hormone Replacement Therapy (HRT). Women with breast cancer, therefore, are at risk for developing osteoporosis. How is osteoporosis diagnosed? Osteoporosis is diagnosed with a Bone Mineral Density (BMD) test. There are many ways to test for bone density, but most techniques use a specialized low-dose X-ray technique that measures the amount of bone present in different parts of the skeleton. Lower bone density is associated with greater risk for fractures. Your measurements are compared to women similar in age, weight, sex and ethnic background. The test most commonly performed at UCSF is the Dual Energy X-Ray Absorptiometry (DXA), which is safe and not uncomfortable. The radiation exposure is less than one-tenth the dosage of a chest X-ray. You will be asked to wear clothes without metal buttons, buckles, or zippers and no underwire bra. The test is performed fully clothed. You will lie on a table and the scanning arm is moved slowly over the parts of the body to be scanned. You are not in a tunnel as with an MRI. The test takes about 15-30 minutes. Your primary care physician or your physician in the Breast Care Center can order a Bone Mineral Density test if you are at risk for or have symptoms of osteoporosis. When and how often should testing be done? Testing might be discussed and considered in the following instances:
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