Bone Disease in Breast Cancer: The Era of New Targeted Therapies

Abstract

Breast cancer is the most common malignancy among women in the United States. Treatments for breast cancer can have significant effects on bone. Chemotherapy use in premenopausal women often leads to premature menopause, resulting in accelerated loss of bone mineral density. Hormonal therapy, particularly aromatase inhibitors in postmenopausal women, can also decrease bone density. In addition, a majority of patients with metastatic breast cancer have bony involvement, leading to bone pain, increased risk of fracture, and other morbidities. Thus, a thorough understanding of factors associated with cancer therapy-induced bone loss and treatment options are essential to providing quality care to cancer survivors. This article summarizes risk factors, evaluation, and treatment options for cancer therapy-induced bone loss and metastatic bone disease in breast cancer. In addition, emerging data regarding new targeted therapies and the effect of bonetargeted agents on breast cancer recurrence are discussed.