Hormone- and chemotherapy-induced bone loss in breast cancer

Hormonal and chemotherapies have been shown to have a profound, positive impact on survival in cancer patients but are associated with adverse effects on bone. The abrupt decrease in bone mineral density caused by these therapies is an emerging treatment challenge. In particular, as the aromatase inhibitors are more widely used, studies indicate that there will be an increased fracture risk. Adjuvant therapy with selective estrogen receptor modifiers spares bone loss in postmenopausal women but not in premenopausal women. Thus other strategies to protect bone are needed. This article discusses various treatments that attempt to offset this bone loss--mainly the protective effects of several bisphosphonates.