Zometa and previous fracture

I was diagnosed with Her2+ stage IV breast cancer with mets to the liver, lymph and bones in March 2008 (original diagnosis was June 2005).   I am 59 years old and postmenopausal.  I am currently being treated with Herceptin, Tykerb and Xeloda,   Zometa was recently added.  I have had 2 treatments so far, the second one was yesterday.  Since the first treatment 6 weeks ago, I have had pain in my proximal humerus which was fractured in 2006.  I have  had significantly more pain in that area since yesterday's treatment, making even chopping with a knife or rubbing with a sponge difficult.

I have been told that the pain I experienced after the first Zometa treatment would not cause the pain in my old fracture.  However, since yesterday's treatment has clearly increased the pain, I question that.  Is there anything known about Zometa and previous fractures?     As with any drug, there are risks and benefits to weigh.   Does this indicate a risk factor that I should be aware of?

Thank you.

[Cleveland Clinic]

Dear borealis, Bone pain is a common side effect of Zometa treatment, infrequently there have been reports of severe bone pain.  The onset of pain ranged from a single day to several months. Symptoms usually resolve upon discontinuation. Some patients experienced recurrence of pain when rechallenged with same drug or another bisphosphonate.  These reports have not been specific in relating the bone pain to sites of prior fractures.   In some cases when pain (joint/muscle and/or bone pain) has been debilitating the recommendation would be to avoid use of these medications.   As you state the risks and benefits would need to be weighed – which are best discussed with your oncologist, who would evaluate the bone pain in context of your situation.