Treatment of bone metastases in carcinoma of breast

Like other metastases, bone metastases in breast cancer patients are not on ly a sign of the incurable nature of the underlying disease, but are also a ssociated with specific complications. In particular, bone pain and patholo gical fractures impair the quality of life of those affected. Any treatment concept must therefore place the highest priority on preventing or reducin g skeletal complications. There are two treatment options local and systemi c. Local therapy includes radiotherapy as well as surgical and orthopedic m easures. The four pillars of systemic treatment are hormone therapy and che motherapy, antiresorptive therapy with bisphosphonates and treatment with c entrally and/or peripherally acting analgesics. A precondition for successf ul treatment is close cooperation between gynecologists, internists/oncolog ists, radiotherapists, surgeons/orthopedists, pain specialists and endocrin ologists (in the presence of a hypercalcemic syndrome). Patients with breas t cancer associated solely with osseous metastasis may survive for a number of years. It is therefore all the more important to start appropriate ther apeutic measures in good time. Bisphosphonates play a particularly Valuable role, since their main effect lies in the prevention of skeletal complicat ions. Rather than replacing antineoplastic therapy, this class of substance s supplements other treatments. Once started, bisphosphonate therapy should be given life-long, even in the event of osseous progression.