# Effects of Selective and Nonselective Beta Blockers on Bone Mineral Density in Mexican Patients with Breast Cancer

## TL;DR

Nonselective beta blockers may help prevent bone loss in Mexican breast cancer patients, offering a promising treatment for osteoporosis and osteopenia.

## Contribution

The study shows that nonselective beta blockers improve bone mineral density in breast cancer patients compared to other treatments.

## Key findings

- Patients treated with nonselective beta blockers had higher bone mineral density than those treated with diuretics or no treatment.
- No cases of osteoporosis or osteopenia were observed in patients treated with nonselective beta blockers.
- Selective beta blockers showed limited osteoprotective effects compared to nonselective beta blockers.

## Abstract

Breast cancer (BCa) is a pathology that affects the world population. Patients present risk factors for osteopenia and osteoporosis, such as chronic stress, estrogen deprivation due to hormonal treatment, a menopausal status, and decreased physical activity. An available alternative is the use of nonselective beta blockers (nsBBs) that have antitumoral properties, and in other diseases, antiresorptive and osteoforming effects. We demonstrated that BCa patients taking nsBBs had a greater bone mineral density and a lower incidence of osteoporosis and osteopenia than untreated patients. Although our study has several limitations, such as its retrospective design and single-center population, it revealed promising effects of nsBBs on the prevention and treatment of osteoporosis and osteopenia in patients with BCa.

Breast cancer (BCa) is related to chronic stress and can reduce the bone mineral density (BMD) through neurochemicals related to beta-adrenergic receptor (ADRB) 1 and 2. Selective beta blockers (sBBs) and nonselective beta blockers (nsBBs) are used to treat systemic arterial hypertension (SAH) and may have osteoprotective effects, as they inhibit ADRBs. To evaluate the effects of sBBs and nsBBs on the BMD of Mexican patients with BCa. A retrospective study was conducted. We included 191 Mexican women with BCa without SAH and with SAH treated with nsBBs, sBBs, and diuretics. BMD was evaluated using a bone density scan (DEX scan). A greater average BMD (p < 0.05) was observed in patients with prior treatment with both nsBBs and sBBs (0.54 ± 0.94 and −0.44 ± 1.22, respectively) compared to patients treated with diuretics or without SAH (−1.73 ± 0.83 and −1.22 ± 0.98, respectively). Regarding the diagnosis of osteoporosis/osteopenia, no cases were observed in patients treated with nsBBs, whereas 5.6% of the patients treated with sBBs presented osteopenia. A total of 23.1% and 10.6% patients managed with diuretics or without treatment presented with osteoporosis and 61.5% and 48% patients managed with loop diuretics and without treatment presented with osteopenia, respectively (p < 0.05). Treatment with nsBBs is a promising option for the prevention and management of osteoporosis/osteopenia in Mexican patients with BCa; however, further prospective studies are needed.