Adjuvant Bisphosphonate Therapy in Postmenopausal Breast Cancer Patients

摘要

Adjuvant bisphosphonate therapy is increasingly used in postmenopausal breast cancer patients. This is based on level-one evidence that bisphosphonates, particularly zoledronic acid, can effectively prevent cancer treatment-induced bone loss in breast cancer patients receiving estradiol-lowering endocrine therapies such as aroma-tase inhibitors. Furthermore, emerging data from large clinical trials suggest that additional anti-cancer benefits can be derived due to a positive impact on the bone marrow microenvironment. Breast cancer is the leading cause of cancer-related deaths among women worldwide [1]. Advances in treatment for breast cancer have substantially improved survival and clinical outcomes in recent years [2]. For endocrine-responsive breast cancer, endocrine therapy has become the standard adjuvant treatment after locoregional treatment. Endocrine therapies for breast cancer profoundly decrease circulating estrogen levels. This can be associated with marked decreases in bone mineral density (BMD) in some patients. Aromatase inhibitors (AIs) are nowadays the endocrine therapy of choice in postmenopausal women with endocrine-responsive breast cancer [3].