Bisphosphonates in bone metastases of breast cancer

Background: Like other metastases, bone metastases in breast cancer patients are not only a sign of the incurable nature of the underlying disease, but are also associated with specific complications. In particular, bone pain and pathological fractures impair the quality of life of those affected. Any treatment concept must therefore place the highest priority on preventing or reducing skeletal complications. Therapy: There are 2 treatment options - local and systemic. Local therapy includes radiotherapy as well as surgical and orthopedic measures. The 4 pillars of systemic treatment are hormone therapy and chemotherapy, antiresorptive therapy with bisphosphonates and treatment with centrally and/or peripherally acting analgesics. A precondition for successful treatment is close cooperation between gynecologists, medical/clinical oncologists, radiotherapists, surgeons/orthopedists, pain specialists and endocrinologists (in the presence of a hypercalcemic syndrome). Conclusion: Patients with breast cancer associated solely with osseous metastasis may survive for a number of years. It is therefore all the more important to start appropriate therapeutic measures in good time. Bisphosphonates play a particularly valuable role, since their main effect lies in the prevention of skeletal complications. Rather than replacing antineoplastic therapy, this class of substances supplements other treatments. Once started, bisphosphonate therapy should be given life-long, even in the event of osseous progression.