Breast Cancer Overview

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Treating Breast Cancer TOPICS

Bone-directed therapy for breast cancer

When cancer spreads to the bones, it can weaken them and even lead to the bones breaking. The cancer in the bone can also cause pain. Drugs like bisphosphonates and denosumab can help prevent those problems.

If you’d like more information on a drug used in your treatment or a specific drug mentioned in this section, see our Guide to Cancer Drugs , or call us with the names of the medicines you’re taking.


Bisphosphonates are used when breast cancer has spread to the bones. These drugs can strengthen bones that have been weakened by invading breast cancer cells and reduce the risk of pain, fractures or breaks. The drugs most often used to treat breast cancer that has spread to bone are pamidronate (Aredia®) and zoledronic acid (Zometa®. Both of these drugs are given into a vein (IV), often once a month.

Bisphosphonates may also help prevent bone thinning (osteoporosis) that can result from treatment. When used to prevent bone thinning, bisphosphonates that you cantake by mouth are most often used.

Bisphosphonates can have side effects, including flu-like symptoms and bone pain. They can also cause kidney damage and can’t be used in patients with kidney problems. A rare but serious side effect from bisphosphonates is damage in the jaw bone. It can be triggered by having a tooth pulled while being treated with the bisphosphonate. It often appears as an open sore in the jaw that won't heal. Doctors don't know why this happens. Most doctors recommend that patients have a dental check-up and have any tooth or jaw problems treated before they start taking bisphosphonates.


Denosumab (Xgeva®, Prolia®) is newer drug that can be used to help reduce the risk of problems from breast cancer that has spread to the bone. It is given as an injection under the skin, once a month.

It can also be used to prevent osteoporosis. When it is used for that reason, it only needs to be given twice a year.

Side effects can include low blood levels of calcium and phosphate. It can also cause the same jaw bone problem as bisphosphonates. It doesn’t cause kidney problems, though.

Last Medical Review: 09/17/2013
Last Revised: 01/31/2014