Objective: Breast cancer survivors are at increased risk of bone complications, indicating the need to better understand the effects of necessary treatments on bone health. The role of chemotherapy in bone loss is unclear, and its influence over time is not understood. This integrative review examined the existing literature on chemotherapy-induced bone loss in patients with early-stage, curative breast cancer focusing on long-term outcomes. Evaluating the mechanisms of chemotherapy-induced bone loss in humans along with preclinical (animal) models may elucidate pathways and improve care by providing targets for bone health-related interventions.
Data sources: A review of retrieved articles dated January 2010 to December 2020 from MEDLINE and EMBASE databases were searched. A total of six clinical (human) and three preclinical (animal) studies were included.
Conclusion: The findings identified two main themes (1) indirect and direct cellular mechanisms of chemotherapy-induced bone loss and (2) long-term bone complications and symptoms in breast cancer survivors. Implications for pre- and postmenopausal women are presented.
Implications for nursing practice: Enhanced bone surveillance performed by the specialized oncology nurse can improve long-term bone health outcomes. Prospective analyses evaluating short- and long-term chemotherapy-induced bone loss are recommended for future clinical trials to inform practice and evidence-informed interventions and treatments.
Keywords: Adjuvant; Breast neoplasm; Chemotherapy; Osteoporosis; Senescence; Skeletal.
Copyright © 2022 Elsevier Inc. All rights reserved.