108 patients with a diagnosis of breast cancer were studied; the average age was 58.49±11.01 years,
with a range of 48 years (34 to 48 years).
In table 1 the frequencies of the risk factors related to lifestyle and comorbidities.
29.6% of the patients were overweight and 16.7% were obese,
the minimum BMI was 18 kg/m2 and the maximum was 39 kg/m2.
In respect to the gynaeco-obstetrical history,
the frequency of early menarche was 3.7% (4 cases),
none of the patients presented late menopause and only 4.6% (5 cases) were nulliparous.
The stage III-IV had a frequency of 22.2% (24 cases),
the metastasis frequency at the moment of the diagnosis was of 20.4% (22 cases).
The women who were in stage III-IV had 18 times more risk (confidence interval was 95% of 5.83-56.14),
so the metastasis was related a 68.2% to the stage III-IV (p=0.0001).
On the other hand,
only 9.3% (10 cases) were treated with hormone therapy and 37.4% (40 cases) with surgery.
Table 2 presents the frequencies of the histopathologic markers evaluated in the tumour tissue of the patients.
The most frequent marker and subtype was Her2 and the ER negative respectively.
The result of the bone density evaluated by DEXA showed that 55.6% of the patients presented osteoporosis/osteopenia (45.4% osteopenia,
10.2% osteoporosis).
The result of the DEXA was related to the age of risk for menopause and stage III-IV (see table 3). Table 4 shows the averages of the results of the bone density evaluated by CT scan of the patients with breast cancer,
taking as a reference the result of the DEXA study,
both global and classified according to the age of risk for menopause and the tumour stage.
Globally,
patients with osteoporosis had 50% less bone density evaluated by CAT scan in relation to the patients with normal bone density,
in patients aged >48 years was 43%,
in < of 48 years was 69%,
in stage III-IV was 58% and in stage I-II-III was 46%.
In figure 9 it is presented the ROC curve,
were the maximum sensibility and specificity point for the CAT scan (HU) is showed in relation to the DXA result.
The optimal cut-off point was <157HU for osteoporosis /osteopenia in patients with breast cancer,
reaching an 82% of sensibility and a 68% of specificity,
with an area below the curve of 0.76 (p=0.0001) and a confidence interval of 95% from 0.67 to 0.86. Taking into account as a cut-off point <157HU as a parameter of bone density for osteoporosis/osteopenia for patients with breast cancer comparing it with the DXA values to evaluate bone density in healthy patients,
it is possible to notice a relation of the PR-positive of 58%,
ER-negative of 35.4%,
(p>0.05),
but a high number of cases both ER-negative (25 cases) and PR-positive (31 cases).
These results suggest that the normal parameters of osseous density in the densitometry must be reestablished when determined in oncological patients.
The Hounsfield Units obtained by CT are correlated with age (r= -0.53,
p=0.0001).
See figure 10 It is positively correlated with the determination of 1 DXA (rho= +0.43,
p=0.0001),
DEXA of 2 (rho= +0.47,
p=0.0001),
DXA of 3 (rho= +0.49,
p=0.0001) and to the result of SD (rho= + 0.53,
p=0.0001).