Breast cancer is a leading threat to women's health.
Tamoxifen, the most successful
selective estrogen receptor modulator, has been used in hormonal
therapy for three decades. Along with its
therapeutic effect on
breast cancer,
tamoxifen also demonstrates potential benefits for bone health. However, the extent and quality of such benefits have not been systematically evaluated. We conducted a comprehensive literature search and identified 27 peer-reviewed articles investigating the relationship between
tamoxifen and bone health in postmenopausal women with early stage
breast cancer. The majority of studies reported that
tamoxifen therapy alone protected against the loss of spinal bone mineral density. The bones in the hip also benefited from
tamoxifen treatment while there was no evidence demonstrating
tamoxifen's protection against bone loss in arms. When
tamoxifen was combined with
chemotherapy, it was found to partially prevent or reverse the bone loss resulting from
chemotherapy. Patients with a history of
hormone replacement therapy experienced bone loss while patients without the history had increased bone mineral density during
tamoxifen therapy. Despite an apparent impact of
tamoxifen on bone mineral density, the few available studies of
tamoxifen and
bone fractures appear to suggest no protective effect but an increase in fracture incidence. More investigation is necessary to clarify the discrepancy between bone mineral density and fracture in postmenopausal
breast cancer patients treated with
tamoxifen.