American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the primary purpose of using bisphosphonates in breast cancer patients?

1. To enhance tumor shrinkage

2. To reduce bone pain and skeletal complications

3. To prevent cancer recurrence

4. To improve overall survival rates

The correct answer is: To reduce bone pain and skeletal complications

The primary purpose of using bisphosphonates in breast cancer patients is to reduce bone pain and skeletal complications. Breast cancer, particularly when it has metastasized to the bone, can lead to various issues such as pain, fractures, and pathologic changes in the bone structure. Bisphosphonates are effective in addressing these complications by inhibiting osteoclast-mediated bone resorption, thereby stabilizing bone and alleviating pain associated with bone metastases. While bisphosphonates may have some ancillary benefits in terms of preventing skeletal-related events and possibly assisting in reducing pain, their primary clinical application in this context is to manage and mitigate the skeletal complications associated with the cancer. This use is especially relevant as breast cancer is one of the cancers that may commonly spread to the bones, making the management of bone health critical. The other options, though relevant in a broader context of cancer care, do not align with the primary role of bisphosphonates. Their use in enhancing tumor shrinkage or preventing cancer recurrence is not supported by strong evidence and practice protocols; rather, such effects are not the primary rationale for their administration in breast cancer patients. Likewise, while there may be discussions around overall survival rates in the context of specific