incidence of osteonecrosis of the jaw in breast cancer patients
 

on bisphosphonates

Cancer. 2009 Jan 20. [Epub ahead of print] Links

Incidence of bisphosphonate-associated osteonecrosis of the jaws in breast cancer patients.

Walter C, Al-Nawas B, du Bois A, Buch L, Harter P, Grötz KA.
Klinik für Mund-, Kiefer- und Gesichtschirurgie Johannes Gutenberg-Universität Mainz, Mainz, Germany.
BACKGROUND:: Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is a relatively new disease. The aim of this study was to evaluate the prevalence of BP-ONJ in breast cancer patients with osseous metastasis and bisphosphonate therapy. METHODS:: A retrospective study was conducted in a EUSOMA accredited breast unit in Germany. All patients treated from January of 2000 to March of 2006 with metastatic breast cancer and bisphosphonate therapy were reviewed. All patients were contacted, and missing data were completed through structured interviews with their dentists and physicians (n = 75). Primary outcome was the development of BP-ONJ and the detection of possible additional trigger factors for the development of BP-ONJ. RESULTS:: A total of 117 patients with breast cancer fulfilled the inclusion criteria, and data for 75 still living patients were included. Of these 75, 4 patients developed a BP-ONJ, resulting in a prevalence of 5.3%: 3 patients received zoledronate only; 1 patient had first pamidronate followed by zoledronate and ibandronate. A tooth extraction could be identified as an additional trigger factor for 2 patients. CONCLUSIONS:: With a prevalence of 5.3%, BP-ONJ in breast cancer patients has become a relevant disease that should be discussed with patients for whom bisphosphonates have been recommended. Appropriate dental care before bisphosphonate therapy commences has been advised to reduce the occurrence of BP-ONJ. Cancer 2009. (c) 2009 American Cancer Society.
PMID: 19156913

Lani, am I correct that according to the article, the ONJ results were for those who were given Zometa, not Fosomax or Actinol, right?

I believe all bisphosphonates are at issue.

I know that zolondronate is Zometa - if that helps read the results.

Last year I attended a presentation at a dental convention. The topic was biophosphantes and osteonecrosis of the jaw. The information I received was that the risk of ONJ is primarily with IV biophosphantes (Zometa). The risk is not impossible, but extremely low for the oral meds (Actinol, Fosomax).