Atypical Femoral Fractures (AFF) from Bone Remodeling Agents in Patients with Cancer

Anticancer Res. 2018 Nov;38(11):6439-6444. doi: 10.21873/anticanres.13005.

Abstract

Anti-resorptive drugs like bisphosphonates (BP) and denosumab are widely used for prevention and treatment of skeletal diseases, such as osteoporosis and bone metastases and mainly work through the prevention of osteoclast-mediated bones resorption. BP can lead to atypical femoral fractures (AFF) that is a rare, easily misdiagnosed treatment-related complication with great impact on the quality of life of patients. We present a concise review of the literature on BP related AFF based on the cases of 3 breast cancer patients that reflect the diagnostic pitfall of this rare entity. In conclusion, breast cancer patients very often are exposed to BP use and are at risk of developing AFF.

Keywords: AFF; antiresorptive; atypical femoral fracture; bisphosphonates; cancer.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bone Density Conservation Agents / adverse effects*
  • Breast Neoplasms / complications*
  • Denosumab / adverse effects
  • Diphosphonates / adverse effects
  • Female
  • Femoral Fractures / chemically induced*
  • Femoral Fractures / diagnostic imaging
  • Humans
  • Middle Aged
  • Quality of Life
  • Radiography

Substances

  • Bone Density Conservation Agents
  • Diphosphonates
  • Denosumab