Summary Recommendations

Guideline Recommendations

Use of Bisphosphonates to Preserve Bone Health in Postmenopausal Women Initiating Adjuvant Aromatase Inhibitors in Breast Cancer

History and physical examination, baseline bone mineral density (BMD) and annual height measurements, lifestyle modifications. T-score >-1: Rescreen in 1 year. If 1-year BMD >-1.0, screen every 1-2 years. T-score between -1.0 and -1.5: annual screening. T-score between -1.5 and -2.0: check vitamin D level [25(OH)D]. Consider bisphosphonate therapy depending on risk factors. T-score <-2.0: check vitamin D level [25(OH)D]. Treat with bisphosphonate therapy.

Use of Adjuvant Bisphosphonates to Improve Breast Cancer Outcomes

Bisphosphonates reduce the frequency of bone metastases and improve survival in postmenopausal women (natural or induced) with breast cancer (I, A). Bisphosphonates do not improve disease outcomes in premenopausal women (I, A).