Aromatase inhibitors (AIs) are routinely prescribed as adjuvant hormonal therapy for postmenopausal women with hormone receptor positive breast cancer. Aromatase inhibition with its profound estradiol (estrogen) depletion, is associated with an increased risk of low bone mineral density and osteoporosis with increased fracture risk. The potential impact of AIs and their resulting hormone ablation on oral health and oral health related quality of life in women with breast cancer is undefined. A project will be conducted at University of Michigan in a multidisciplinary environment. A cross-sectional study will be used to assess the prevalence of oral symptoms among 150 post-menopausal women with a history of early stage breast cancer receiving adjuvant AI therapy and 150 postmenopausal women without cancer recruited from the University of Michigan Health System in Southeastern Michigan. Comprehensive oral examinations (including assessment of mucosal lesions, periodontal measures, dental caries, oral x-rays, oral fluid, and tooth loss examination will be performed). Questionnaires assessing socio-demographic and behavioral factors as well as quality of life information will be administered to all participants. Logistic regression modeling will be used to analyze the strengths of associations as appropriate. This proposal provides a comprehensive plan for the career development of Dr. Linda Susan Taichman in the area of oral health as it pertains to adjuvant therapy and breast cancer survivorship. Short-term goals are to acquire skills in clinical research expertise in patient centered studies and to gain knowledge of adjuvant aromatase inhibitor related oral effects necessary for independent investigations of endocrine therapies and oral health. Long-term goals are to strengthen the linkage between Medical education and Dentistry by developing evidence-based physician guideline strategies aimed at improving the health and healthcare of breast cancer survivors. The didactic training and mentored research activities will provide Dr. Taichman with the foundation from which she can submit highly competitive grant applications in the final years of the award and develop future studies to understand optimal oral care for breast cancer survivors. The proposed research is relevant to that part of NIDCR's mission that pertains to developing fundamental knowledge concerning oral health related effects of cancer therapies. Ultimately, this information may improve the dental health professional's and the oncologist's ability to anticipate and mitigate oral toxicities from AI therapy.
This project will explore oral health in the context of aromatase inhibitors. A constellation of clinical oral health assessments, periodontal biomarkers and oral health related quality of life data will be used for understanding how current therapeutic modalities impact not just the cancer, but the risk for development of oral health problems. Patients, dental professionals and medical oncologists will benefit from a greater understanding of the best oral care follow up practices of breast cancer survivors.
