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Recommendation
Adjuvant bisphosphonate treatment – Premenopausal women
Consider the use of zoledronic acid as adjuvant therapy for premenopausal women receiving ovarian suppression.
Adjuvant bisphosphonate therapy may be considered in young women receiving ovarian suppression; however, data are limited in young women and impact on future progeny unknown (Level of evidence – moderate)
It is recommended that administration of bisphosphonates as adjuvant therapy be considered for postmenopausal patients with breast cancer (including patients premenopausal before treatment who have menopause induced by ovarian suppression as detailed in Recommendation 5) deemed candidates for adjuvant systemic therapy.
Strong recommendation, moderate quality evidence. Strong recommendation, can apply to most patients in most circumstances without reservation
How this guidance was developed
This recommendation was adapted from the ESO-ESMO 2017 guidelines for young women (Europe). The source recommendation was based on a review of the evidence (date of review not indicated, considered by the expert panel in November 2016) and was graded ‘B’ (using ACCP methods). The source recommendation was adapted by making stylistic changes by, removing some of the detail. The recommendation and level of evidence has remained unchanged in the ESO-ESMO 2020 update.
The recommendation is supported by a recommendation in the CCO/ASCO 2017 clinical practice guideline on the use of adjuvant bisphosphonates and other bone-modifying agents in breast cancer.
It is noted that zoledronic acid is not TGA-approved for this indication.
Related guidance by topic
Adjuvant bisphosphonate treatment – Premenopausal women
Recommendation
Consider the use of zoledronic acid as adjuvant therapy for premenopausal women receiving ovarian suppression.
Principles in action
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Supportive care
This recommendation was adapted from the ESO-ESMO 2017 guidelines for young women (Europe). The source recommendation was based on a review of the evidence (date of review not indicated, considered by the expert panel in November 2016) and was graded ‘B’ (using ACCP methods). The source recommendation was adapted by making stylistic changes by, removing some of the detail. The recommendation and level of evidence has remained unchanged in the ESO-ESMO 2020 update.
The recommendation is supported by a recommendation in the CCO/ASCO 2017 clinical practice guideline on the use of adjuvant bisphosphonates and other bone-modifying agents in breast cancer.
It is noted that zoledronic acid is not TGA-approved for this indication.
Related guidance by topic
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