title: Characteristics of the early stages of intravenous bisphosphonate-related osteonecrosis of the jaw in patients with breast cancer.
abstract: OBJECTIVE
  The clinical features of the early stages of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in patients with breast cancer remain unclear. A retrospective cohort study was conducted of patients with breast cancer who received intravenous bisphosphonate (BP) treatment in a single center in order to clarify the status of the early stages of BRONJ.
  
  
  METHODS
  A BRONJ oral monitoring program was established in 247 breast cancer patients given intravenous BP treatment at the institution. The differences in age, BP treatment period, number of remaining teeth, oral hygiene status, presence of regular oral monitoring and the existence of suspected BRONJ (stage 0) among eight BRONJ and 36 non-BRONJ subjects who completed oral examinations were then compared.
  
  
  RESULTS
  BRONJ was observed in 0.4% of subjects on the first visit to the oral surgery clinic and in 3.2% of subjects during the follow-up period. Logistic regression analysis revealed that the odds ratio for identifying patients with BRONJ during follow-up by the presence of stage 0 at first visit was 24.0 (95% confidence interval [CI] = 3.6-161.7). The area under the receiver operating characteristic curve for identifying subjects with BRONJ by the presence of stage 0 was 0.82 (95% CI = 0.63-1.00).
  
  
  CONCLUSIONS
  The results suggest that patients with stage 0 BRONJ on the first visit may progress to advanced BRONJ during the follow-up period. The oral monitoring program may contribute to the early detection of BRONJ.
authors: Department of Oral and Maxillofacial Surgery.
authors: Akira
authors: A
authors: Matsuo
authors: Hayato
authors: H
authors: Hamada
authors: Hiroshi
authors: H
authors: Kaise
authors: Daichi
authors: D
authors: Chikazu
authors: Kimito
authors: K
authors: Yamada
authors: Norio
authors: N
authors: Kohno
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000175:diagnosis*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000517:prevention & control / Q000556:secondary; D001943:Breast Neoplasms / Q000628:therapy*; D015331:Cohort Studies; D003817:Dentition; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects*; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates
keywords: bisphosphonate; breast cancer; oral hygiene; osteonecrosis