HEalth and QUality of life in Oncological patients (Hequobip study): call to definitive guidelines for the improvement of long-term patients’ quality of life

Purpose. There is no current consensus in the counseling about diagnostic and therapeutic guidelines for bone disease in breast cancer (BC) patients. Hence, we aimed to study the current state of clinical and therapeutic approach to bone disease in an Italian BC population treated with adjuvant and/or hormone therapy, alongside overall Quality of Life (QoL). Methods. This observational multicenter longitudinal ambispective study involved four Italian clinical units recruiting patients receiving either Aromatase Inhibitors (AI) or Tamoxifen. Data on BC, bone health, osteoporosis screening, anti-resorptive therapy types and timing were collected. We focused on bone health status and therapeutic approach adopted and adhesion rate to the different indications identified by the scientific board: ESCEO-2017 (I); ASCO-2019 (II); Note-79-AIFA-Determination (III). Results. 555 women (mean age 54.2 ± 9.5 years) were finally enrolled, most in iatrogenic menopause (62.2%). Half of patients (50.3%) had osteopenia, whilst only 18.4% osteoporosis. DXA exam was performed in 52.6% of cases within the first 24 months after BCtherapy. At enrollment, only 7% of patients received anti-resorptive therapy, whilst after they reached 48.3% of women, mainly Denosumab. Followed indications were mainly “type-III” (46.7%) vs. 16.6% “type-I” and “4.1% “type-II”. Patients showed a moderate impairment of global QoL referred to anxiety and depression, alongside an impairment in mobility and pain. Conclusion. Although clinicians indicate bone screening, they more often prescribe antiresorptive therapy without considering precise guidelines. This study focused on the need for a potential standardized approach to long-term management, which may lead to an improved Qol in BC patients. Trial registration number. Clinicaltrial.gov: NCT04055805.