title: Bisphosphonate induced osteonecrosis of jaw in breast cancer patients: A systematic review.
abstract: BACKGROUND
  Bisphosphonate therapy is widely used for the treatment of bone metastasis in breast cancer patients.
  
  
  OBJECTIVE
  The aim of this study is to estimate the overall prevalence of bisphosphonate induced osteonecrosis of jaw (BONJ) in breast cancer patients with bone metastasis.
  
  
  METHODS
  A literature review was conducted to search and evaluate all the articles that contained original data on the prevalence of BONJ in breast cancer patients from the year 2003-2009. Pubmed search terms used were bisphosphonate, osteonecrosis, breast cancer and jaw. Eleven publications that fulfilled the inclusion criteria were chosen for the study. Case reports and reviews were excluded from the analysis based on assessing the title and abstract.
  
  
  RESULTS
  Of the 2490 breast cancer patients, 69 developed BONJ with the overall prevalence rate of 2.8%. All the patients with BONJ had received zoledronate or pamidronate, either alone or in combinations.
  
  
  CONCLUSIONS
  BONJ is a significant complication occurring in 2.8% of the breast cancer patients receiving bisphosphonates for metastatic bone disease. It is very important to identify the trigger factors associated with BONJ and also to establish guidelines for the prevention and effective treatment of this condition.
authors.affiliation: Department of Oral and Maxillofacial Pathology, PMS Institute of Dental Science and Research, Trivandrum, Kerala, India.
authors.forename: Br
authors.initials: B
authors.lastname: Varun
authors.forename: Tt
authors.initials: T
authors.lastname: Sivakumar
authors.forename: Bindu J
authors.initials: BJ
authors.lastname: Nair
authors.forename: Anna P
authors.initials: AP
authors.lastname: Joseph