Kamal S Saini, MD, MRCP (UK), DM  
Male, 47
Bangalore, India

Specialties: Medical Oncology

Interests: Cancer, Lung Cancer, Chemotherapy
Bangalore Institute of Oncology
Medical Oncology
Bangalore, India
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Bisphosphonates in Breast Cancer

Mar 29, 2009 - 16 comments

zoledronic acid




Breast Cancer









Zoledronic acid has found acceptance among the oncology community for a number of applications. These include tumor induced hypercalcemia, for reducing bone pain from skeletal metastases, reducing skeletal-related events, osteoporosis, and for possibly delaying (or even preventing) skeletal metastases.

Janet E Brown and Robert E Coleman . The role of bisphosphonates in breast cancer: The present and future role of bisphosphonates in the management of patients with breast cancer. Breast Cancer Res 2002, 4:24-29


Cochrane Review

Bone is the most common site of metastatic disease associated with breast cancer (BC). Bisphosphonates inhibit osteoclast-mediated bone resorption.

To assess the effect of Bisphosphonates on skeletal events (SEs), bone pain, quality of life (QOL) and survival in women with early (E) and advanced breast cancer (ABC).

Bisphosphonates reduce the incidence of skeletal events. Women with ABC and clinically evident bone metastases treated with Bs showed significant delays in the median time to SE. Treatment with Bisphosphonates does not appear to affect survival in women with ABC. Bisphosphonates in women with ABC without clinically evident bone metastases do not reduce SE incidence.

Authors' conclusions
In women with ABC and clinically evident bone metastases, Bisphosphonates (PO,IV)) reduce the risk of developing SEs and SE rate, as well as delaying the time to SE. Some Bisphosphonates may also reduce bone pain and may improve QOL.

Pavlakis N, Schmidt RL, Stockler MR. Bisphosphonates for breast cancer. Cochrane Database of Systematic Reviews 2005, Issue 3. Art. No.: CD003474.