Leslie WD, et al. - Researchers focused on fracture outcomes in relation to aromatase inhibitors (AIs) use in breast cancer patients. They used a population-based bone mineral density (BMD) registry. Participants included women aged at least 40 years starting AIs for breast cancer with at least 12 months of AI exposure (n = 1,775), women with breast cancer not taking AIs (n = 1,016), and women from the general population (n = 34,205). Higher body mass index (BMI), higher BMD, lower osteoporosis prevalence, and fewer prior fractures were observed at baseline in AI users vs women from the general population or women with breast cancer without AI use. The risk for major osteoporotic fractures, hip fracture, or any fracture, was not significantly greater in AI users vs general population, after adjusting for all covariates. They concluded that the adverse influences of AI exposure may be offset by higher baseline BMI, BMD, and lower prevalence of prior fracture at baseline. The opinion that high risk for fractures should be considered in all women with breast cancer starting AI therapy is challenged by the findings of this study.