How Does Endocrine Therapy Affect Bones in Breast Cancer?
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A structured, online, multicomponent exercise model lasting 12 weeks showed promising results for bone health, physical capacity, and self-efficacy.
- Increased risk of osteopenia and osteoporosis
- Higher fracture risk
- Joint pain and stiffness
- Reduced functional capacity
- Lower quality of life
The literature shows that exercise may support bone health. However, sustainability, adherence, and behavioral change are the greatest barriers. The ROSE program aims to fill this gap.
What Is the ROSE Program?
ROSE (Rebuilding Osteo Strength with Exercise) is an online, multicomponent bone health management program lasting 12 weeks.
12 Weeks
Modules on bone health awareness, osteoporosis knowledge, and behavioral change
3 Components
Aerobic + Impact + Resistance exercises (individualized plan)
Participants were monitored with a fitness wristband; exercise plans were adjusted using heart rate and physical activity data.
Feasibility and Adherence Rates
No serious adverse events were reported throughout the program.
Clinical Outcomes: What Improved?
| Parameter | ROSE Group | Control |
|---|---|---|
| Bone Mineral Density (BMD) | Slight positive trend | Minimal change |
| Aerobic Capacity (2-minute step test) | Significant increase | Limited change |
| Muscle Strength | Increase (handgrip + functional tests) | No marked increase |
| Pain & Stiffness (WOMAC) | Trend toward reduction | Stable |
| Osteoporosis Knowledge | Increase | Limited change |
An Important Nuance: Why Is the BMD Change Limited?
Nevertheless, the increase in physical capacity and self-efficacy lays the groundwork for a potential protective effect on bone health over the long term.
The ROSE program is not merely an exercise protocol. It is a multicomponent model integrating education, behavioral change, and individualized exercise.
Clinical Implications:
- Bone health should be routinely monitored in patients receiving endocrine therapy.
- Exercise recommendations should be structured rather than passive.
- Resistance exercises should be made suitable for integration into daily life.
- Improving knowledge and self-efficacy is the key to sustainability.
Exercise is not a supportive treatment; it is an active component of oncological care.
References
- Feasibility and preliminary outcomes of a Rebuilding Osteo Strength with Exercise (ROSE) program for breast cancer survivors. European Journal of Oncology Nursing, 2026.
Sources
Chen L, Zhao Y, Yang A, et al. Feasibility and preliminary outcomes of a Rebuilding Osteo Strength with Exercise (ROSE) program for Women with Breast Cancer undergoing endocrine therapy. European Journal of Oncology Nursing. 2026.
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