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Recommendation
Adjuvant bisphosphonate treatment – Postmenopausal women
Consider the use of zoledronic acid as adjuvant therapy for postmenopausal women with breast cancer with a moderate to high risk of recurrence.
Offer bisphosphonates (zoledronic acid or sodium clodronate) as adjuvant therapy to postmenopausal women with node-positive invasive breast cancer
Consider bisphosphonates (zoledronic acid or sodium clodronate) as adjuvant therapy for postmenopausal women with node-negative invasive breast cancer and a high risk of recurrence
How this guidance was developed
This recommendation was adapted from the NICE 2018 guidelines (UK). Two source recommendations on bisphosphonate use were merged. Both source recommendations were based on a systematic review conducted to September 2017: one used wording (‘Offer’) indicative of a strong recommendation and the other used wording (‘Consider’) indicative of a conditional recommendation (using GRADE methods). The source recommendations were adapted by removing reference to sodium clodronate as this is no longer available in Australia, and by making the recommendation less directive due to the merging of the two source recommendations. It is noted that zoledronic acid is not TGA-approved for this indication.
Adjuvant bisphosphonate treatment – Postmenopausal women
Recommendation
Consider the use of zoledronic acid as adjuvant therapy for postmenopausal women with breast cancer with a moderate to high risk of recurrence.
Principles in action
Discuss out of pocket costs
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Supportive care
This recommendation was adapted from the NICE 2018 guidelines (UK). Two source recommendations on bisphosphonate use were merged. Both source recommendations were based on a systematic review conducted to September 2017: one used wording (‘Offer’) indicative of a strong recommendation and the other used wording (‘Consider’) indicative of a conditional recommendation (using GRADE methods). The source recommendations were adapted by removing reference to sodium clodronate as this is no longer available in Australia, and by making the recommendation less directive due to the merging of the two source recommendations. It is noted that zoledronic acid is not TGA-approved for this indication.