Aromatase inhibitors (AI) are often used as hormone therapy drugs to slow down or stop the enlargement of hormone receptor-positive tumours among postmenopausal women. These inhibitors block aromatase enzyme, thus reducing body estrogen levels and inhibiting the cancer growth. The most common side effects associated with their use are bone loss, increased risk of fractures and osteoporosis.

Tremblay et al. conducted a retrospective review on postmenopausal women diagnosed and treated for breast cancer from the period 2010 to 2015. A total of 319 women were included in the study and assessed further. The median age of patients was 65 years, and the span of AI therapy defined was 28 months. The DEXA (Dual-energy X-ray Absorptiometry) scan was performed at the median frequency of 24 months to analyse the bone loss. The median number of DEXA scan was 1 for every woman.

According to multiple guideline recommendations, initial antiresorptive treatment among 15–54% of women was irrelevant. A total of 52 women obtained antiresorptive therapies with Denosumab, Bisphosphonates or both drugs. The recommendations for Vitamin D and Calcium were also evaluated, which was 59% and 66 %, respectively.

As per the single healthcare system, the study determined that about 15–52% antiresorptive treatments were irrelevant. A specific range of diversity was noticed in guideline recommendations, which has various implications for cost-effectiveness, value-of-care analyses and quality of care for preventing fractures.