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Bisphosphonates for breast cancer

Bisphosphonates help to strengthen bones and prevent them from breaking down. Bisphosphonates can be used for breast cancer that has spread to the bone (bone metastases). They are used to:

  • relieve bone pain caused by bone metastases
  • help strengthen bone and reduce the risk of fractures caused by bone metastases
  • help reduce bone fractures in women who are on aromatase inhibitors as a treatment for breast cancer

Bisphosphonates are not used to prevent bone metastases in women with breast cancer that has either:

  • not spread
  • spread to organs other than the bone

Vitamin D and calcium citrate may be given along with bisphosphonates to help strengthen bone.

Different types of bisphosphonates have different uses in breast cancer. For more detailed information on specific drugs, go to sources of drug information.

Bone metastases

The types of bisphosphonates used to treat bone metastases from breast cancer are:

  • clodronate (Bonefos)
    • may be given by mouth (orally) as a pill or as an injection into the vein (intravenously)
  • pamidronate (Aredia)
    • given intravenously
  • zoledronic acid (Zometa, Aclasta)
    • given intravenously

Along with bisphosphonate therapy, other methods of pain management may be offered for women who have pain from bone metastases.


Osteoporosis is a condition in which there is loss of bone mass (density) and bone tissue deteriorates. Bones may break easily because they become weak, brittle and fragile.

Osteoporosis is a long-term side effect of aromatase inhibitors used to treat breast cancer.

The bisphosphonates used to prevent and treat osteoporosis include:

  • alendronate (Fosamax)
    • may be given by mouth (orally) as a pill or a liquid
  • risedronate (Actonel)
    • given by mouth (orally) as a pill
  • etidronate (Didrocal, Didronel)

See a list of questions to ask your doctor about bisphosphonates.


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