Introduction: In most patients, metastatic breast cancer (MBC) is incurable. Consequently, the goal in this setting is life prolongation and quality of life improvement, although possible long-term effects of anticancer treatment need to be considered. Bone is the most common site of metastasis in breast cancer and its complex management includes minimizing the risk of skeletal-related events (SRE), maximizing pain control, stabilizing or even restoring function, preventing spinal cord compression, hypercalcemia of malignancy and fractures and reducing the need for radiotherapy and orthopedic surgery. Aim: The present paper aims to compare the efficacy and safety of zoledronic acid (and other bisphosphonates) with denosumab in the management of bone metastases in breast cancer patients. Materials and methods: In this article, required information was collected through literature review and keyword query using the PRISMA 2020 guideline. Conclusions: In the metastatic setting, it appears that denosumab is indeed superior to zoledronic acid in delaying and preventing skeletal related events, except for spinal cord compression and risk of surgery, and equally efficient in treatment of already present bone pain and hypercalcemia of malignancy, with similar adverse effects, overall survival and disease progression.
Introduction: Breast cancer continues to be the most frequent malignancy in women worldwide. Considerable advances in oncology over the years have led to decreased mortality in early stage (EBC) and locally advanced (ABC) breast cancer, but this has raised concerns about possible long-term effects of anticancer treatment nonetheless. Purpose: The present paper aims to describe the efficacy and safety of osteoclast inhibitors, both as antiresorptive agents, reducing osteoporosis and fracture risk, and as adjuvant anticancer agents, potentially improving disease-related outcomes in patients with early stage and locally advanced breast cancer. Materials and methods: In this article, literature sources were selected and evaluated using the PRISMA 2020 guideline. Conclusions: Bisphosphonates are recommended for early stage and advanced breast cancer patients, either premenopausal or postmenopausal, with osteoporosis. Denosumab may also be used for postmenopausal women. Bisphosphonates also showed a statistically significant benefit for overall survival in postmenopausal women only. However, denosumab is not presently used for indications other than prevention or treatment of osteoporosis.
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