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Cochrane on Bisphosphonates for Breast Cancer

Cochrane; 2017 Oct 30; O'Carrigan, Wong, et al

Bisphosphonates reduce the risk of bone metastases in women with breast cancer and enable those who take them to live longer than those receiving placebo or no bisphosphonates, according to a Cochrane review of 44 studies involving >37,000 individuals.

In women with early breast cancer, bisphosphonates:

  • Probably lowered the risk of cancer spreading to the bone.
  • Improved survival, but the benefit in the whole group was small.
  • Improved survival and reduced the risk of cancer returning in postmenopausal women.

In women with metastatic breast cancer that spread to the bone:

  • Bisphosphonates reduced fractures and bone pain.
  • They did not appear to increase the length of time women survived.
  • Quality of life was slightly better for women who took bisphosphonates.
  • Denosumab reduced the risk of complications compared to bisphosphonates, but it did not produce a survival benefit.

In women with advanced breast cancer, bisphosphonates did not reduce the risk of cancer spreading to the bone or improve survival.

Citation:

O'Carrigan B, Wong M, Willson M, Stockler M, Pavlakis N, Goodwin A. Bisphosphonates and other bone agents for breast cancer. Cochrane Database of Syst Rev. 2017, Issue 10. Art. No.: CD003474. doi:10.1002/14651858.CD003474.pub4.