Potential implications of adjuvant endocrine therapy for the oral health of postmenopausal women with breast cancer

Breast Cancer Res Treat. 2013 Jan;137(1):23-32. doi: 10.1007/s10549-012-2217-z. Epub 2012 Sep 18.

Abstract

Current adjuvant treatment modalities for breast cancer that express the estrogen receptor or progesterone receptor include adjuvant anti-estrogen therapies, and tamoxifen and aromatase inhibitors. Bone, including the jaw, is an endocrine-sensitive organ, as are other oral structures. This review examines the potential links between adjuvant anti-estrogen treatments in postmenopausal women with hormone receptor positive breast cancer and oral health. A search of PubMed, EMBASE, CENTRAL, and the Web of Knowledge was conducted using combinations of key terms "breast," "cancer," "neoplasm," "Tamoxifen," "Aromatase Inhibitor," "chemotherapy," "hormone therapy," "alveolar bone loss," "postmenopausal bone loss," "estrogen," "SERM," "hormone replacement therapy," and "quality of life." We selected articles published in peer-reviewed journals in the English. The authors found no studies reporting on periodontal diseases, alveolar bone loss, oral health, or oral health-related quality of life in association with anti-estrogen breast cancer treatments in postmenopausal women. Periodontal diseases, alveolar bone density, tooth loss, and conditions of the soft tissues of the mouth have all been associated with menopausal status supporting the hypothesis that the soft tissues and bone of the oral cavity could be negatively affected by anti-estrogen therapy. As a conclusion, the impact of adjuvant endocrine breast cancer therapy on the oral health of postmenopausal women is undefined. The structures of the oral cavity are influenced by estrogen; therefore, anti-estrogen therapies may carry the risk of oral toxicities. Oral health care for breast cancer patients is an important but understudied aspect of cancer survivorship.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Alveolar Bone Loss / prevention & control
  • Antineoplastic Agents, Hormonal / adverse effects
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Aromatase Inhibitors / adverse effects
  • Aromatase Inhibitors / therapeutic use
  • Breast Neoplasms / drug therapy*
  • Chemotherapy, Adjuvant
  • Estrogen Replacement Therapy*
  • Female
  • Humans
  • Neoplasms, Hormone-Dependent / drug therapy*
  • Oral Health
  • Periodontal Diseases / chemically induced
  • Periodontal Diseases / prevention & control
  • Postmenopause
  • Quality of Life

Substances

  • Antineoplastic Agents, Hormonal
  • Aromatase Inhibitors