| Abstract [eng] |
Breast cancer remains a leading cause of premature death in women globally, spurring the adoption of comprehensive treatment approaches. Despite therapeutic progress, significant challenges persist for patients, especially those with advanced breast cancer prone to bone metastases. Bisphosphonates (BPs) and Denosumab (DNB) are key bone-modifying agents (BMAs) used to target bone metabolism, reduce metastatic risk, and enhance adjuvant therapy efficacy in early-stage breast cancer. However, the usage of these agents carries risks, including adverse events such as osteonecrosis of the jaw (ONJ). Due to the impact of these drugs on the jaw bone, this condition is now known as Medication-related osteonecrosis of the jaw (MRONJ).This literature aims to provide a comprehensive investigation into MRONJ in the context of breast cancer treatment, with a specific focus on the effects of antiresorptive drugs (ARDs) such as BPs and DNB. Moreover, the study seeks to address the key question of how the use of ARDs impacts the occurrence of osteonecrosis of the jaw in women with breast cancer. The method of this study is to conduct a literature review to collect information on MRONJ in breast cancer patients. PubMed and Google Scholar databases were searched for English-language articles published between 2012 and January 2024. MRONJ is a condition that occurs in breast cancer patients due to various risk factors. The treatment of MRONJ depends on the different stages of the condition. Recent research suggests that optimal management of patients prone to MRONJ necessitates a multidisciplinary approach, and the dentist is one of the team members who play a crucial role in patient care by assessing modifiable risk factors, establishing follow-up protocols, and maintaining open communication with oncologists. Preventive measures should be implemented before and during treatment with ARD. However, despite growing awareness of MRONJ within the medical community, doctors and dentists still have a poor understanding of the subject. Therefore, this research provides clear, practical guidelines to help prevent, manage, and treat MRONJ in breast cancer patients based on the best evidence review of currently available literature. In conclusion, dentists should follow particular protocols that are published in literature when treating patients who are in pretreatment or under high-dose antiresorptive therapy. The main goals of treating patients with MRONJ or at risk are to prevent and maintain quality of life. Therefore, dental students and dental specialists need to stay updated and pay attention to this side effect. |
