Osteolytic bone
metastases secondary to
breast cancer are extremely common, occurring in more than 50% of
breast cancer patients. The resulting increased
bone resorption leads to significant symptomatic morbidity caused by bone
pain, hypercalcaemia and
pathological fracture.
Clodronate, an anti-osteolytic agent, inhibits osteoclastic
bone resorption and has considerable therapeutic value. Recent studies have shown that
clodronate is effective in the treatment of
malignancy hypercalcaemia, relief of bone
pain and decreases the risk of
pathological fracture. The use of
clodronate in the future, other than as a
palliative therapy, may focus upon the prevention of osteolytic bone
metastases at the time of primary diagnosis or later in the
disease progression in those patients at risk, for example, those with non-osseous relapse. Since patients with bone
metastases secondary to
breast cancer often have an increased duration of survival, any agent that would decrease the symptomatic morbidity would have a significant impact upon quality of life, even more so if the actual development of osteolytic bone
metastases was delayed or prevented.