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In the ATAC trial, researchers compared the efficacy of anastrozole (Arimidex), tamoxifen, and the combination of anastrozole plus tamoxifen as adjuvant therapy for women with invasive breast cancer (Journal Watch Oncology and Hematology Jan 22 2008). Anastrozole, an aromatase inhibitor, lowers estrogen levels; low estrogen levels in older women are associated with decreases in bone-mineral density (BMD). To assess long-term effects of anastrozole on BMD, investigators (some employed by the pharmaceutical sponsor of the trial) conducted a study in a subset of patients who participated in the ATAC trial.
One hundred ninety-seven women who were randomized to the monotherapy arms of the ATAC trial were recruited for the bone substudy. Exclusion…