title: Prevention and Treatment of Bone Metastases in Breast Cancer.
abstract: In breast cancer patients, bone is the most common site of metastases. Medical therapies are the basic therapy to prevent distant metastases and recurrence and to cure them. Radiotherapy has a primary role in pain relief, recalcification and stabilization of the bone, as well as the reduction of the risk of complications (e.g., bone fractures, spinal cord compression). Bisphosphonates, as potent inhibitors of osteoclastic-mediated bone resorption are a well-established, standard-of-care treatment option to reduce the frequency, severity and time of onset of the skeletal related events in breast cancer patients with bone metastases. Moreover bisphosphonates prevent cancer treatment-induced bone loss. Recent data shows the anti-tumor activity of bisphosphonates, in particular, in postmenopausal women and in older premenopausal women with hormone-sensitive disease treated with ovarian suppression. Pain is the most frequent symptom reported in patients with bone metastases, and its prevention and treatment must be considered at any stage of the disease. The prevention and treatment of bone metastases in breast cancer must consider an integrated multidisciplinary approach.
authors.affiliation: Supportive Care in Cancer Unit, Department of Haematology and Pediatric Onco-Haematology Fondazione IRCCS, Istituto Nazionale dei Tumori di Milano, Milan 20133, Italy. carla.ripamonti@istitutotumori.mi.it.
authors.forename: Ripamonti
authors.initials: R
authors.lastname: Carla
authors.affiliation: Oncology Department, Radiation Oncology Centre, Santa Maria Hospital, Via T. di Joannuccio, Terni 05100, Italy. f.trippa@aospterni.it.
authors.forename: Trippa
authors.initials: T
authors.lastname: Fabio
authors.affiliation: Supportive Care in Cancer Unit, Department of Haematology and Pediatric Onco-Haematology Fondazione IRCCS, Istituto Nazionale dei Tumori di Milano, Milan 20133, Italy. gloria.barone@istitutotumori.mi.it.
authors.forename: Barone
authors.initials: B
authors.lastname: Gloria
authors.affiliation: Oncology Department, Radiation Oncology Centre, Santa Maria Hospital, Via T. di Joannuccio, Terni 05100, Italy. e.maranzano@aospterni.it.
authors.forename: Maranzano
authors.initials: M
authors.lastname: Ernesto
keywords: bisphosphonates; bone metastases; bone pain relief; breast cancer; chemotherapy; endocrine therapy; radiotherapy