title: Bisphosphonate-related atypical femoral fracture with bone metastasis of breast cancer: case report and review.
abstract: BACKGROUND
  Intravenous bisphosphonates (BPs) have been used to reduce the frequency of skeletal-related events due to bone metastases of several kinds of cancers. Although many studies on BP-related atypical fractures (BRAFs) due to the use of BP for osteoporosis treatment have been reported, few reports on BRAFs arising as a complication of long-term BP use for bone metastasis of cancer are available.
  
  
  METHODS
  A 62-year-old woman with a history of breast cancer presented with right thigh pain after she had a fall. Radiographs indicated a transverse fracture in the shaft of the right femur. She had been on zoledronate treatment for six years. Based on radiographic and histopathological findings, we concluded that the fracture was not a pathological fracture associated with metastasis but was a complication of long-term BP treatment.
  
  
  CONCLUSIONS
  Clinical oncologists should consider the possibility of BRAFs in patients on long-term zoledronate treatment for bone metastases.
authors.affiliation: 2-13-22 Miyakojimahondori Miyakojima-ku, Osaka, 534-0021 Japan. kh_ocg@yahoo.co.jp.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Hayashi
authors.forename: Masanari
authors.initials: M
authors.lastname: Aono
authors.forename: Kousuke
authors.initials: K
authors.lastname: Shintani
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kazuki
mesh_terms: D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000556:secondary; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D004164:Diphosphonates / Q000009:adverse effects*; D005260:Female; D005264:Femoral Fractures / Q000139:chemically induced*; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects*; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid
keywords: Zoledronate; atypical femoral fracture; bone metastasis; breast cancer