Comprehensive Clinical Literature Review of Managing Bone Metastases in Breast Cancer: Focus on Pain and Skeletal-Related Events

Clin J Oncol Nurs. 2023 Nov 16;27(6):615-628. doi: 10.1188/23.CJON.615-628.

Abstract

Background: Bone metastases are the most common site of metastatic disease in breast cancer and can result in significant pain and an increased risk of skeletal-related events (SREs). Uncontrolled pain can further lead to negative outcomes.

Objectives: The aim is to provide oncology nurses with the latest evidence on the management of bone metastases in metastatic breast cancer (MBC) with a focus on pain and SREs.

Methods: A literature search was conducted using the Embase®, PubMed®/MEDLINE®, CINAHL®, and Cochrane Library databases. Clinical trials, retrospective studies, systematic reviews, meta-analyses, and practice guidelines, as well as one high-level conference abstract, were reviewed.

Findings: Options for managing bone metastases in MBC include surgical and interventional strategies, radiation, and bone-modifying agents. Management plans frequently include a combination of these modalities. More information is needed to better define the role of bone-directed therapies in MBC, particularly as they relate to nursing care.

Keywords: bone metastases; breast cancer; pain; pain management; symptom management.

Publication types

  • Review

MeSH terms

  • Bone Density Conservation Agents* / therapeutic use
  • Bone Neoplasms* / drug therapy
  • Bone Neoplasms* / secondary
  • Breast Neoplasms* / drug therapy
  • Diphosphonates / therapeutic use
  • Female
  • Humans
  • Pain / drug therapy
  • Pain / etiology
  • Retrospective Studies

Substances

  • Diphosphonates
  • Bone Density Conservation Agents