Bone-Targeted Therapy in Early Breast Cancer

  • Ece Esin
  • Irfan CicinEmail author


Early-stage breast cancer has a favorable prognosis, so long-term survivorship is important. Systemic adjuvant therapy may result in chronic adverse events, including osteoporosis. Accelerated bone loss may occur with systemic chemotherapy, gonadotropin-releasing hormone antagonists, aromatase inhibitors and tamoxifen. Major preventive measures such as cessation of smoking, control of thyroid hormone functions and optimized vitamin D and calcium intake should be encouraged for all patients. Bisphosphonates and the receptor activator of nuclear factor kappa-B ligand inhibitor (denosumab) have proven efficacy against systemic therapy-induced osteoporosis. The data supporting the use of bone-targeted agents as adjuvant treatment in early breast cancer are evolving continuously. In meta-analyses, the impact of bisphosphonates and denosumab on breast cancer survival benefit has been seen mainly in postmenopausal women. In addition, bisphosphonates and denosumab exhibit toxicity. Hypocalcemia, renal toxicity, gastrointestinal intolerance and osteonecrosis of the jaw are the main complications of bone-targeted therapy and need to be carefully managed.


Bone Targeted therapy Bisphosphonates Denosumab Osteonecrosis 


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Medical Oncology Dr. A. Y. Ankara Oncology Education and Research HospitalAnkaraTurkey
  2. 2.Department of Medical Oncology, Faculty of Medicine, Balkan Oncology HospitalTrakya University of MedicineEdirneTurkey

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