Review Article

Association Use of Bisphosphonates with Risk of Breast Cancer: A Meta-Analysis

Table 2

Bisphosphonate use of the studies included in the meta-analysis.

Study (year)Type of breast cancerType of BPsDefinition of exposureMeasure of BP useAverage exposure period (years)Adjustment for covariates

Cardwell (2011) [6]Breast cancerBPOne or more prescriptions of oral BPsMedical record4.5Smoking, alcohol, BMI, HRT, oral steroids, NSAIDs, calcium, and vitamin D
Chiang (2012) [7]Breast cancerALNPrescriptions of oral ALNMedical record4.8Age, hypertension, diabetes, COPD, estrogen, dyslipidemia, CKD, CAD, colorectal polyp, benign breast disease, obesity, and statin use
Chlebowski (2010) [8]Invasive breast cancer & DCISBPOne or more oral BPsSelf-report7.8Age, ethnicity, smoking, alcohol, physical activity, BMI, mammogram, estrogen, progesterone, calcium, vitamin D, hip fracture, and Gail 5 y risk of breast cancer
Fournier (2017) [9]Invasive breast cancer & DCISBPOne or more oral BPsSelf-report7.2Age, BMI, time since menopause, HRT, calcium, and vitamin D
Hue (2014) [10]Breast cancerALN & ZAOral ALN or ZAMedical record3.8Age, BMI, smoking, ethnicity, age at first pregnancy, and family of breast cancer history
Lee (2012) [11]Breast cancerALNPrescriptions of oral ALNMedical record3.04Age
Monsees (2011) [12]Contralateral breast cancerBP & ALNOne or more BPsMedical record≥1Progesterone receptor, status of the first primary breast cancer, height, weight, BMI, diagnosed with osteoporosis or osteopenia, mammography, therapies received or first breast cancer, chemotherapy, radiation, parity, menopausal status, alcohol, smoking, HRT, and first-degree family history of breast cancer
Newcomb (2010) [13]Invasive breast cancerBPOne or more BPsSelf-report5Age, parity, age at first live birth, family history of breast cancer, BMI, menopausal status, age at menopause, type of hormone use, mammography, osteoporosis, smoking, height, HRT, and self-reports of medication use
Rennert (2010) [14]Breast cancerBP & ALNOne or more prescriptions of oral BPsMedical record5Family of breast cancer history, age, sports activity, Jewish ethnic group, fruit vegetable consumption, BMI, statin, aspirin, calcium, vitamin D, HRT, red meat consumption, number of pregnancies, months of breast feeding, and age at first pregnancy
Vestergaard (2011) [16]Breast cancerALN, CLN, ETN, & RINOne or more dispensations of oral BPsMedical recordNAUse of systemic hormone therapy, irradiation, chemotherapy, and alcoholism
Vinogradova (2013) [15]Breast cancerBP, ALN, ETN, & RINOne or more prescriptions of oral BPsMedical record1.67BMI, smoking, alcohol, ethnicity, comorbidity, and use of other drugs

Abbreviations: BPs: bisphosphonates; DCIS: ductal carcinoma in situ; ALN: alendronate; ZA: zoledronic acid; CLN: clodronate; ETN: etidronate; RIN: risedronate; NA: not available; BMI: body mass index; HRT: hormone replacement therapy; NSAIDs: nonsteroidal anti-inflammatory drugs; COPD: chronic obstructive pulmonary disease; CKD: chronic kidney disease; CAD: coronary artery disease.