When do you add an adjuvant bone-modifying agent in patients with history of localized breast cancer?

In my opinion this is controversial question. The meta-analysis performed by EBCTG 2016 of over 11,000 post-menopausal women, and over 6000 premenopausal women, clearly shows a benefit for the postmenopausal subset. The absolute overall survival improvement was 3.3% (p=0.002) for postmenopausal wome...

Guidelines including ASCO/CCO, NCCN, St Gallen's, and ESMO all endorse the use of adjuvant bisphosphonates in early-stage breast cancer for postmenopausal women (natural or through suppression) at moderate to high risk of recurrence to reduce recurrence and fracture/BMD loss based on the patient lev...

Dr. @Dr. First Last and Dr. @Dr. First Last both give reasonable answers.

It appears at a first glance that postmenopausal women with osteoporosis risk receive most of the benefit from adjuvant bisphosphonate. I also give zoledronic acid q6m x 3-5 years in post-menopausal women at high enough risk o...