Scoping review of biologic and imaging markers associated with aromatase inhibitor related musculoskeletal symptoms
Year: 2026
Type: article
Abstract: Background: ) breast cancer, yet up to half experience aromatase inhibitor-associated musculoskeletal symptoms (AIMSS) that reduce quality of life and compromise adherence. We aim to better understand the biologic and imaging factors involved in AIMSS, which may improve early identification and management of these toxicities. Methods: disease. Biomarker categories included inflammatory cytokines [C-reactive protein (CRP), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1)], metabolic and lipidomic profile [oxylipins, 8-hydroxyeicosatetraenoic acid (8-HETE)], hormonal markers (estradiol, sex hormone-binding globulin) and genetic polymorphisms (CYP19A1, ESR1, HSD17B2). Results: Elevated inflammatory and metabolic markers and lower estradiol levels on AI treatment were associated with AIMSS in several studies, while genetic associations were inconsistent, though newer work identified variants such as HSD17B2. Imaging approaches included ultrasound, magnetic resonance imaging (MRI), and shear wave elastography (SWE), with early and serial imaging showing potential for detecting tendon or soft tissue changes preceding symptoms. SWE may be a quantifiable tool for identifying early biomechanical changes. One study highlighted body mass index (BMI) as a potential clinical factor and proposed insulin-like growth factor as an unmeasured biomarker candidate. Conclusions: Overall, inflammatory and hormonal pathways, novel genetic variants, and early imaging changes represent promising approaches for understanding AIMSS. Larger, standardized studies that integrate these biologic and imaging data are needed to improve risk prediction and support adherence to endocrine therapy.
Institutions: University of New Mexico, UNM Comprehensive Cancer Center
Language: English
Subfield: Cancer Research
Domain: Life Sciences
Open Access status: hybrid
OpenAlex ID: W7212428379