Bisphosphonate drugs are bone density medications (also called bone-modifying agents) that help prevent bone loss (osteoporosis). They are used in breast cancer treatment and care.

Breast cancer treatment

Bisphosphonates are used to treat some women with early breast cancer [7,72]. These drugs may lower the risk of breast cancer coming back (recurrence) [70-71].

If you are postmenopausal (either naturally or through ovarian suppression) and will get chemotherapy or hormone therapy after breast surgery, your oncologist may recommend the bisphosphonate zolendronic acid (Zometa) as part of your treatment [72].

Zolendronic acid is given by vein (through an IV) every 6 months for 3-5 years [72].

Breast cancer care

Bone density medications are used to prevent or manage side effects in:

• Women taking an aromatase inhibitor
• Women with early menopause related to breast cancer treatment
• Women with breast cancer that has spread to the bones (bone metastases)

Health risks

Talk with your oncologist about possible side effects and health risks that may occur while taking zolendronic acid.

Osteonecrosis of the jaw

Although rare, bisphosphonates can cause osteonecrosis of the jaw, a serious jawbone disorder [123-124]. This is mostly a concern for people with metastatic breast cancer who take high doses of bisphosphonates.

It’s recommended you have a dental exam (along with any dental works that needs to be done) before you start treatment with zolendronic acid [7,123]. Also, talk with your oncologist before getting any dental procedure while taking zolendronic acid [7,123].

Under study

The RANK ligand (RANKL) inhibitor drug denosumab is another bone density medication used to help prevent and manage bone-related side effects women with breast cancer, including those with bone metastases.

The use of denosumab to lower the risk of breast cancer recurrence is under study [74]. However, most data do not show denosumab offers a benefit [74].

Learn more about denosumab in the care of people with bone metastases.

Updated 08/19/21