What are the Cancer Care Ontario and ACSO joint guidelines on the use of bisphosphonate therapy for bone health in postmenopausal women with breast cancer?

Updated: Nov 06, 2019
  • Author: Winston W Tan, MD, FACP; Chief Editor: Marie Catherine Lee, MD, FACS  more...
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In March 2017, Cancer Care Ontario and the American Society of Clinical Oncology (ASCO) issued a joint clinical practice guideline that recommends considering a bisphosphonate as adjuvant therapy for all postmenopausal women with early breast cancer who are deemed to be candidates for adjuvant therapy. The recommendation applies to women who have undergone natural menopause or menopause induced by ovarian suppression or ablation. [20]

The guidelines recommend the use of either zoledronic acid or clodronate; data on adjuvant denosumab, although promising, were found to be insufficient to support a recommendation. The recommended regimen for zoledronic acid is 4 mg intravenously (infused over 15 minutes or longer) every 6 months for 3 to 5 years. Clodronate is given in a dosage of 1,600 mg/d orally for 2 to 3 years. [20]

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