Approach to Bone Health in the Patient with Breast Cancer

Treatment for breast cancer, including endocrine therapies, can contribute to bone loss and increase the risk of osteoporosis and fractures. Management of bone health in cancer patients is often coordinated between oncologists, endocrinologists, and primary care physicians. In this article we discuss the approach to screening for fracture risk among patients initiating treatments for breast cancer, and recommendations for lifestyle modifications to optimize bone health. We will review three indications for pharmacologic bone-targeted therapies: prevention of cancer treatment-induced bone loss, adjuvant therapy to reduce recurrence, and management of bone metastases.