Evidence map›Paper›PMID 39163561›Full record

ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2025

Incidence of Medication-Related Osteonecrosis of the Jaw in Patients With Breast Cancer During a 20-Year Follow-Up: A Population-Based Multicenter Retrospective Study.

Christine Brunner, Marjan Arvandi, Christian Marth, Daniel Egle, Florentina Baumgart, Miriam Emmelheinz, Benjamin Walch, Johanna Lercher, Claudia Iannetti, Ewald Wöll and 14 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed.

  1. Trial
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  3. A qualitative analysis of dental challenges for oncology patients receiving bone-modifying agents.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Christine BrunnerDepartment of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria.ORCID 0000-0003-0296-3719
Marjan ArvandiDepartment of Public Health, Health Services Research and Health Technology Assessment, Medical Decision Making and Health Technology Assessment, Institute of Public Health, UMIT TIROL-University for Health Sciences and Technology, Hall in Tirol, Austria.
Christian MarthDepartment of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria.ORCID 0000-0002-8965-9981
Daniel EgleDepartment of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria.ORCID 0000-0003-0283-8176
Florentina BaumgartDepartment of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria.
Miriam EmmelheinzDepartment of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria.ORCID 0000-0002-2734-2153
Benjamin WalchDepartment of Cranio-Maxillofacial and Oral Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Johanna LercherDepartment of Cranio-Maxillofacial and Oral Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Claudia IannettiDepartment of Visceral, Transplant and Thoracic Surgery (VTT), Center of Operative Medicine, Medical University of Innsbruck, Innsbruck, Austria.
Ewald WöllDepartment of Internal Medicine, St Vinzenz Hospital, Zams, Austria.
Agnes PechlanerDepartment of Internal Medicine, St Vinzenz Hospital, Zams, Austria.
August ZaberniggDepartment of Internal Medicine, County Hospital Kufstein, Kufstein, Austria.
Birgit VolggerDepartment of Obstetrics and Gynecology, County Hospital Lienz, Lienz, Austria.ORCID 0009-0007-3120-4347
Maria CastellanDepartment of Obstetrics and Gynecology, County Hospital Lienz, Lienz, Austria.
Oliver Tibor AndraschofskyDepartment of Obstetrics and Gynecology, State Hospital Hall, Hall, Austria.
Alice MarklDepartment of Visceral Surgery, State Hospital Hall, Hall, Austria.
Michael HubalekDepartment of Obstetrics and Gynecology, County Hospital Schwaz, Schwaz, Austria.
Michael SchnallingerDepartment of Internal Medicine, County Hospital St Johann, St Johann, Austria.
Sibylle PuntscherDepartment of Public Health, Health Services Research and Health Technology Assessment, Medical Decision Making and Health Technology Assessment, Institute of Public Health, UMIT TIROL-University for Health Sciences and Technology, Hall in Tirol, Austria.ORCID 0000-0002-0591-7067
Uwe SiebertDepartment of Public Health, Health Services Research and Health Technology Assessment, Medical Decision Making and Health Technology Assessment, Institute of Public Health, UMIT TIROL-University for Health Sciences and Technology, Hall in Tirol, Austria.
Sebastian SchönherrDivision of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria.
Lukas ForerDivision of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria.
Emanuel BruckmoserPrivate Practice for Oral and Maxillofacial Surgery, Salzburg, Austria.ORCID 0000-0001-7154-5735
Johannes LaimerDepartment of Cranio-Maxillofacial and Oral Surgery, Medical University of Innsbruck, Innsbruck, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMedication-related osteonecrosis of the jaw (MRONJ) is one of the most important toxicities of antiresorptive therapy, which is standard practice for patients with breast cancer and bone metastases. However, the population-based incidence of MRONJ is not well established. We therefore performed a retrospective multicenter study to assess the incidence for a whole Austrian federal state (Tyrol). MATERIALS AND

methodsThis retrospective multicenter study was conducted between 2000 and 2020 at all nine breast centers across Tyrol, Austria. Using the cancer registry, the total Tyrolean population was screened for all patients with breast cancer. All patients with breast cancer and bone metastases receiving antiresorptive therapy were finally included in the study.

resultsFrom 8,860 patients initially screened, 639 individuals were eligible and included in our study. Patients received antiresorptive therapy once per month without de-escalation of therapy. MRONJ was diagnosed in 56 (8.8%, 95% CI, 6.6 to 11.0) patients. The incidence of MRONJ was 11.6% (95% CI, 8.0 to 15.3) in individuals treated with denosumab only, 2.8% (95% CI, 0.7 to 4.8) in those treated with bisphosphonates only, and 16.3% (95% CI, 8.8 to 23.9) in the group receiving bisphosphonates followed by denosumab. Individuals developed MRONJ significantly earlier when treated with denosumab. Time to MRONJ after treatment initiation was 4.6 years for individuals treated with denosumab only, 5.1 years for individuals treated with bisphosphonates only, and 8.4 years for individuals treated with both consecutively.

conclusionMRONJ incidence in breast cancer patients with bone metastases was found to be considerably higher, especially for patients receiving denosumab, when compared with available data in the literature. Additionally, patients treated with denosumab developed MRONJ significantly earlier.

Indexed as

Bisphosphonate-Associated Osteonecrosis of the JawBone Density Conservation AgentsBone NeoplasmsBreast NeoplasmsAdultAgedAged, 80 and overAustriaDenosumabDiphosphonatesFemaleFollow-Up StudiesHumansIncidenceMiddle AgedRetrospective StudiesBone Density Conservation AgentsDenosumabDiphosphonates

Identifiers

PMID39163561
PMCPMC11708989

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.