Incidence of bisphosphonate-associated osteonecrosis of the jaws in breast cancer patients.
BACKGROUND
Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is a relatively new disease. The aim of this study was to evaluate the prevalence of BP-ONJ in breast cancer patients with osseous metastasis and bisphosphonate therapy.


METHODS
A retrospective study was conducted in a EUSOMA accredited breast unit in Germany. All patients treated from January of 2000 to March of 2006 with metastatic breast cancer and bisphosphonate therapy were reviewed. All patients were contacted, and missing data were completed through structured interviews with their dentists and physicians (n = 75). Primary outcome was the development of BP-ONJ and the detection of possible additional trigger factors for the development of BP-ONJ.


RESULTS
A total of 117 patients with breast cancer fulfilled the inclusion criteria, and data for 75 still living patients were included. Of these 75, 4 patients developed a BP-ONJ, resulting in a prevalence of 5.3%: 3 patients received zoledronate only; 1 patient had first pamidronate followed by zoledronate and ibandronate. A tooth extraction could be identified as an additional trigger factor for 2 patients.


CONCLUSIONS
With a prevalence of 5.3%, BP-ONJ in breast cancer patients has become a relevant disease that should be discussed with patients for whom bisphosphonates have been recommended. Appropriate dental care before bisphosphonate therapy commences has been advised to reduce the occurrence of BP-ONJ.
Walter
Christian
C
Klinik für Mund-, Kiefer- und Gesichtschirurgie Johannes Gutenberg-Universität Mainz, Mainz, Germany. walter@mkg.klinik.uni-mainz.de
Al-Nawas
Bilal
B
du Bois
Andreas
A
Buch
Laura
L
Harter
Philipp
P
Grötz
Knut A
KA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology*; D004164:Diphosphonates / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007571:Jaw Diseases / Q000139:chemically induced* / Q000453:epidemiology; D008875:Middle Aged; D019647:Oral Surgical Procedures; D010020:Osteonecrosis / Q000139:chemically induced* / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies
D050071:Bone Density Conservation Agents; D004164:Diphosphonates