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Breast Cancer pp 433–441Cite as

Bone-Targeted Therapy in Early Breast Cancer

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Abstract

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.

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Author information

Authors and Affiliations

  1. Department of Medical Oncology, Dr. A. Y. Ankara Oncology Education and Research Hospital, Ankara, Turkey

    Ece Esin

  2. Department of Medical Oncology, Faculty of Medicine, Balkan Oncology Hospital, Trakya University of Medicine, Edirne, Turkey

    Irfan Cicin

Authors
  1. Ece Esin
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  2. Irfan Cicin
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Corresponding author

Correspondence to Irfan Cicin .

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Editors and Affiliations

  1. Internal Medicine, Medical Oncology, Istanbul Medical Faculty, Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey

    Adnan Aydiner

  2. General Surgery, Istanbul Medical Faculty, Department of Surgery, Istanbul University, Istanbul, Turkey

    Abdullah Igci

  3. Surgical Oncology, Magee-Women’s Hospital, University of Pittsburgh Medical Centre, Pittsburgh, PA, USA

    Atilla Soran

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Esin, E., Cicin, I. (2019). Bone-Targeted Therapy in Early Breast Cancer. In: Aydiner, A., Igci, A., Soran, A. (eds) Breast Cancer . Springer, Cham. https://doi.org/10.1007/978-3-319-96947-3_18

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  • DOI: https://doi.org/10.1007/978-3-319-96947-3_18

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