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Prevention and Treatment of Skeletal Complications

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Book cover Management of Breast Cancer in Older Women

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Abstract

Considerable advances in breast cancer care over recent decades have led to improved survival across all age groups. However, this increases the clinical relevance of long-term consequences of anti-cancer treatments, with effects on bone health of particular relevance to the older population of women with breast cancer. The risk of cancer treatment induced bone loss should be considered by clinicians and recent international management guidelines followed. Bone targeting agents, supplemented by calcium and vitamin D supplementation alongside modifications in life-style, can prevent osteoporosis and fractures. Use of bisphosphonates in the adjuvant setting also reduces breast cancer recurrences and deaths in older women.

Bone metastases are common in advanced breast cancer and may cause major morbidity including fractures, pain, nerve compression and hypercalcaemia. Diagnosis may be more difficult in the elderly due to overlapping clinical and imaging features with osteoporotic and degenerative bone diseases. Through optimum multidisciplinary management and use of both systemic treatments to treat the underlying cancer and bone-targeted treatments such as potent bisphosphonates or denosumab to improve the structural integrity of bone, the experience of advanced cancer patients has been transformed with a major reduction in skeletal complications, less bone pain and improved quality of life.

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  1. Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK

    Robert Coleman

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  1. Brighton and Sussex Medical School, Brighton, UK

    Malcolm Reed

  2. Department of Surgery, Sahlgrenska University Hospital, Institute of Clinical Sciences, Gothenburg, Sweden

    Riccardo A. Audisio

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Coleman, R. (2019). Prevention and Treatment of Skeletal Complications. In: Reed, M., Audisio, R. (eds) Management of Breast Cancer in Older Women. Springer, Cham. https://doi.org/10.1007/978-3-030-11875-4_12

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