The Use of Bisphosphonates in Patients With Breast Cancer

Catherine H. Van Poznak, MD


Cancer Control. 2002;9(6) 

In This Article

Abstract and Introduction

Background: Bone is the most common site of breast cancer metastases. Skeletal metastases may be associated with harmful and painful events such as fractures, spinal cord compression, and hypercalcemia. By inhibiting osteoclasts and bone resorption, bisphosphonates can interrupt the process of bone destruction and decrease the risk of skeletal complications.
Methods: A review of the literature was undertaken regarding the use of bisphosphonates in breast cancer management, with particular attention to prospective, randomized clinical trials that have influenced the treatment of bone metastases.
Results: Large prospective, randomized trials have demonstrated that bisphosphonates are effective in reducing skeletal-related complications from metastatic breast cancer.
Conclusions: For many patients with osseous lesions from breast cancer, bisphosphonate therapy is a useful intervention in managing their disease. Bisphosphonates are the treatment of choice for hypercalcemia of malignancy and bisphosphonates reduce the risk of pathologic fractures, spinal cord compromise, the need for radiation or surgery to bone, and bone pain.

Breast cancer incidence in the United States in 2002 is expected to account for approximately 30% of all new cancer cases among women, and mortality due to breast cancer is estimated to comprise 15% of all cancer-related deaths.[1] When managing metastatic dis-ease, the treatment objectives are to optimize treatment response, improve survival, and balance these goals while maintaining the highest possible quality of life. Approximately 65% to 75% of patients with metastatic breast cancer develop osseous metastases.[2] Skeletal metastases are often associated with harmful and painful events such as spontaneous fractures, spinal cord compression, or hypercalcemia.[3] Thus, managing skeletal metastases is an important component of treating patients with metastatic breast cancer.


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