title: Characterization of clinical course and usual care patterns in female metastatic breast cancer patients treated with zoledronic acid.
abstract: OBJECTIVE
  To describe usual care received by women with bony metastatic breast cancer (ICD-9: 174.xx and 198.5) treated in a United States specialty cancer hospital, an Electronic Medical Record (EMR)-based retrospective review identified 111 deceased female breast cancer patients ≥18 years of age treated with zoledronic acid (ZOL).
  
  
  RESULTS
  Baseline symptoms included bone pain/fracture (58.6%), breathing difficulties (24.3%), or mental status changes (11.7%). ZOL was started at/after metastatic diagnosis for 75.7% of women (N = 84), with average administration of 15.9 months (median 11.3). Nearly 20% required reduced ZOL doses, most (54.5%) due to impaired renal function; 61.3% discontinued ZOL due to patient death/disease progression. Adverse events were reported in 10.8%, while 0.9% (N = 1) had a documented osteonecrosis of the jaw.
  
  
  CONCLUSIONS
  Initiation of palliative care should be considered early in patients with a history of metastatic breast cancer who report bone pain or other skeletal-related events.
authors.affiliation: Department of Pharmacotherapy and Pharmacotherapy Outcomes Research Center, University of Utah, 421 Wakara Way, Suite 208, Salt Lake City, UT 84108, USA. jason.young@hsc.utah.edu
authors.forename: Jason
authors.initials: J
authors.lastname: Young
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Nickman
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Biskupiak
authors.forename: Reed B
authors.initials: RB
authors.lastname: Barney
authors.forename: David K
authors.initials: DK
authors.lastname: Gaffney
authors.forename: Madhav
authors.initials: M
authors.lastname: Namjoshi
authors.forename: Patricia
authors.initials: P
authors.lastname: Brandt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000150:complications / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology*; D002277:Carcinoma / Q000150:complications / Q000556:secondary*; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D004164:Diphosphonates / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D005598:Fractures, Spontaneous / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D010166:Palliative Care / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid