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Abstract：
OBJECTIVE: A MASCC/ISOO Clinical Practice Statement (CPS) is aimed at generating a concise tool for clinicians that concentrates practical information needed for the management of oral complications of cancer patients. This CPS raises awareness to the prevention of medication-related osteonecrosis of the jaw (MRONJ) in patients with breast cancer treated with adjuvant bone-modifying agents (BMA).
METHODS: This CPS was developed based on a critical evaluation of the literature followed by a structured discussion of a group of leading experts, members of the Oral Care Study Group of MASCC/ISOO. The information is presented in the form of succinct bullets and tables to generate a short manual about the best standard of care.
RESULTS: In patients treated with adjuvant BMA, dento-alveolar surgery poses a moderate risk for MRONJ that ranges between the high risk for MRONJ in patients with metastatic breast cancer and the low risk for MRONJ in patients with osteoporosis. Existing MRONJ guidelines serve as a starting point for adjuvant BMA use. Urgent procedures should be delivered without delay using the accepted precautions to prevent MRONJ. If elective surgery is considered, the individual risk for MRONJ following surgery should be assessed according to common risk factors.
CONCLUSIONS: Prevention of MRONJ in primary breast cancer patients treated with adjuvant BMA requires risk-benefit assessment; collaboration between the medical team, dental professional, and patient; and patient-specific tailored dental treatment planning. The patient should be informed about this risk. Additional research is needed to define optimal MRONJ care for this population.
METHODS: This CPS was developed based on a critical evaluation of the literature followed by a structured discussion of a group of leading experts, members of the Oral Care Study Group of MASCC/ISOO. The information is presented in the form of succinct bullets and tables to generate a short manual about the best standard of care.
RESULTS: In patients treated with adjuvant BMA, dento-alveolar surgery poses a moderate risk for MRONJ that ranges between the high risk for MRONJ in patients with metastatic breast cancer and the low risk for MRONJ in patients with osteoporosis. Existing MRONJ guidelines serve as a starting point for adjuvant BMA use. Urgent procedures should be delivered without delay using the accepted precautions to prevent MRONJ. If elective surgery is considered, the individual risk for MRONJ following surgery should be assessed according to common risk factors.
CONCLUSIONS: Prevention of MRONJ in primary breast cancer patients treated with adjuvant BMA requires risk-benefit assessment; collaboration between the medical team, dental professional, and patient; and patient-specific tailored dental treatment planning. The patient should be informed about this risk. Additional research is needed to define optimal MRONJ care for this population.
摘要：
目的：MASCC/ISOO临床实践声明（CPS）旨在为临床医生提供一个简洁的工具，集中治疗癌症患者口腔并发症所需的实用信息。该CPS提高了对使用辅助骨改性剂（BMA）治疗的乳腺癌患者预防药物相关的颌骨坏死（MRONJ）的认识。
方法：本CPS是在对文献进行批判性评估的基础上开发的，随后是一组领先专家的结构化讨论。MASCC/ISOO口腔护理研究小组的成员。这些信息以简洁的项目符号和表格的形式呈现，以生成关于最佳护理标准的简短手册。
结果：在接受BMA辅助治疗的患者中，牙槽骨手术对MRONJ的风险中等,范围介于转移性乳腺癌患者MRONJ的高风险和骨质疏松症患者MRONJ的低风险之间.现有的MRONJ指南作为佐剂BMA使用的起点。应使用公认的预防措施立即交付紧急程序，以防止MRONJ。如果考虑择期手术,手术后MRONJ的个体风险应根据常见风险因素进行评估.
结论：在接受BMA辅助治疗的原发性乳腺癌患者中预防MRONJ需要风险-效益评估；医疗团队之间的合作，牙科专业,和患者；以及针对患者的量身定制的牙科治疗计划。应告知患者这种风险。需要更多的研究来确定该人群的最佳MRONJ护理。
方法：本CPS是在对文献进行批判性评估的基础上开发的，随后是一组领先专家的结构化讨论。MASCC/ISOO口腔护理研究小组的成员。这些信息以简洁的项目符号和表格的形式呈现，以生成关于最佳护理标准的简短手册。
结果：在接受BMA辅助治疗的患者中，牙槽骨手术对MRONJ的风险中等,范围介于转移性乳腺癌患者MRONJ的高风险和骨质疏松症患者MRONJ的低风险之间.现有的MRONJ指南作为佐剂BMA使用的起点。应使用公认的预防措施立即交付紧急程序，以防止MRONJ。如果考虑择期手术,手术后MRONJ的个体风险应根据常见风险因素进行评估.
结论：在接受BMA辅助治疗的原发性乳腺癌患者中预防MRONJ需要风险-效益评估；医疗团队之间的合作，牙科专业,和患者；以及针对患者的量身定制的牙科治疗计划。应告知患者这种风险。需要更多的研究来确定该人群的最佳MRONJ护理。
