Do you offer adjuvant bisphosphonates to high-risk premenopausal women on ovarian suppression for early-stage breast cancer who would want to consider pregnancy in the future?

ASCO guidelines from 1/2022 recommend a discussion of bisphosphonate therapy in post-menopausal women or women on ovarian suppression who are candidates for adjuvant therapy, but risks and benefits should be carefully weighed.

In a large meta-analysis of adjuvant bisphosphonate therapy in early breast cancer published in the Lancet October 3, 2015 (EBCTCG, PMID 26211824), there may have been an overall survival benefit in women who were post-menopausal when treatment began, but not in pre-menopau...