Bone metastases represent a common source of morbidity and disability and are the cause of a significant decrease in quality of life in patients with advanced disease. Because the clinical course of metastatic bone disease can be long, effective palliative therapy is essential to maintain a good quality of life. Bisphosphonates have been proven as beneficial agents in the management of patients with lytic metastatic disease to bone. Although no effect on survival has been consistently shown, bisphosphonates can provide specific symptom control and prevent the progression of bone metastases and their complications. Bisphosphonates also have an established role in the prevention and treatment of osteoporosis, which is a significant problem in women with breast cancer, with or without bone metastases. Because bisphosphonate treatment is not designed to be curative, tolerability and patient friend-liness are very important factors in bisphosphonate therapy. Highly potent third-generation bisphosphonates offer significant advantages from the patient's perspective, such as the possibility of outpatient treatment through shortened infusion times for intravenous (IV) formulations, and the availability of once-daily oral formulations.
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