Zoledronic acid for treatment of osteopenia and osteoporosis in women with primary breast cancer undergoing adjuvant aromatase inhibitor therapy

Breast. 2010 Apr;19(2):92-6. doi: 10.1016/j.breast.2009.12.001. Epub 2010 Jan 15.


Background: Postmenopausal women with osteoporosis/osteopenia are at increased risk of fracture. Aromatase inhibitors further increase bone loss in these patients. This study evaluates whether zoledronic acid prevents the bone loss expected when these patients initiate letrozole.

Patients and methods: Postmenopausal women with estrogen and/or progesterone receptor-positive breast cancer and a bone mineral density (BMD) T-score <-2.0 were given letrozole 2.5mg/vitamin D 400 international units daily, calcium 500mg twice daily, and 4mg zoledronic acid every 6 months. The BMD was assessed at baseline and 1 year. The primary endpoint was the mean change in lumbar spine (LS) BMD at 1 year.

Results: Forty-six patients completed 1 year of treatment. LS BMD increased by 2.66% (p=0.01), femoral neck (FN) by 4.81% (p=0.01), and any measured endpoint by 4.55% (p=0.0052).

Conclusions: Zoledronic acid prevents bone loss in postmenopausal women with osteoporosis/osteopenia starting letrozole and is associated with improvements in BMD.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aromatase Inhibitors / administration & dosage
  • Bone Density
  • Bone Density Conservation Agents / administration & dosage*
  • Bone Diseases, Metabolic / drug therapy*
  • Breast Neoplasms / drug therapy
  • Chemotherapy, Adjuvant
  • Diphosphonates / administration & dosage*
  • Female
  • Humans
  • Imidazoles / administration & dosage*
  • Letrozole
  • Nitriles / administration & dosage
  • Osteoporosis / drug therapy
  • Risk Factors
  • Treatment Outcome
  • Triazoles / administration & dosage
  • Zoledronic Acid


  • Aromatase Inhibitors
  • Bone Density Conservation Agents
  • Diphosphonates
  • Imidazoles
  • Nitriles
  • Triazoles
  • Zoledronic Acid
  • Letrozole