Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital

Adjuvant bisphosphonates in early breast cancer: consensus guidance for clinical practice from a European Panel

Research output: Contribution to journalJournal articleResearchpeer-review


  1. L-Lysine increased the cytotoxicity effect of doxorubicin in MDA-MB-231 and MDA-MB-468 breast cancer cell lines

    Research output: Contribution to journalConference abstract in journalResearch

  2. TSGA10 and H2AX competition over binding HIF-1 in breast cancer

    Research output: Contribution to journalConference abstract in journalResearchpeer-review

  1. Whole genome sequencing of breast cancer

    Research output: Contribution to journalReviewResearchpeer-review

  2. Genome-wide association and transcriptome studies identify target genes and risk loci for breast cancer

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Subtypes in BRCA-mutated breast cancer

    Research output: Contribution to journalJournal articleResearchpeer-review

  • P Hadji
  • R E Coleman
  • C Wilson
  • T J Powles
  • P Clézardin
  • M Aapro
  • L Costa
  • J-J Body
  • C Markopoulos
  • D Santini
  • I Diel
  • A Di Leo
  • D Cameron
  • D Dodwell
  • I Smith
  • M Gnant
  • R Gray
  • N Harbeck
  • B Thurlimann
  • M Untch
  • J Cortes
  • M Martin
  • U-S Albert
  • P-F Conte
  • B Ejlertsen
  • J Bergh
  • M Kaufmann
  • I Holen
View graph of relations

Bisphosphonates have been studied in randomised trials in early breast cancer to investigate their ability to prevent cancer treatment-induced bone loss (CTIBL) and reduce the risk of disease recurrence and metastasis. Treatment benefits have been reported but bisphosphonates do not currently have regulatory approval for either of these potential indications. This consensus paper provides a review of the evidence and offers guidance to breast cancer clinicians on the use of bisphosphonates in early breast cancer. Using the nominal group methodology for consensus, a systematic review of the literature was augmented by a workshop held in October 2014 for breast cancer and bone specialists to present and debate the available pre-clinical and clinical evidence for the use of adjuvant bisphosphonates. This was followed by a questionnaire to all members of the writing committee to identify areas of consensus. The panel recommended that bisphosphonates should be considered as part of routine clinical practice for the prevention of CTIBL in all patients with a T score of <-2.0 or ≥2 clinical risk factors for fracture. Compelling evidence from a meta-analysis of trial data of >18,000 patients supports clinically significant benefits of bisphosphonates on the development of bone metastases and breast cancer mortality in post-menopausal women or those receiving ovarian suppression therapy. Therefore, the panel recommends that bisphosphonates (either intravenous zoledronic acid or oral clodronate) are considered as part of the adjuvant breast cancer treatment in this population and the potential benefits and risks discussed with relevant patients.

Original languageEnglish
JournalAnnals of Oncology
Issue number3
Pages (from-to)379-90
Number of pages12
Publication statusPublished - Mar 2016

    Research areas

  • Antineoplastic Agents, Bone Density Conservation Agents, Bone Neoplasms, Breast Neoplasms, Chemotherapy, Adjuvant, Clodronic Acid, Consensus, Diphosphonates, Europe, Female, Humans, Imidazoles, Neoplasm Recurrence, Local, Osteoporosis, Surveys and Questionnaires, Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review

ID: 49707120