Abstract

Background: In the treatment of bone metastases from breast cancer, bisphosphonates are considered the cornerstone of treatment to prevent adverse skeletal related events. Intravenous bisphosphonates reduce bone resorption by inhibiting osteoclast function. However, osteonecrosis of the jaws is a commonly reported side effect with intravenous bisphosphonates to treat malignancies, such as breast cancer and restricts their clinic use. New targeted therapies have recently been introduced to improve progression-free survival in postmenopausal women with estrogen receptor-positive advanced breast cancer. Everolimus is a mammalian target of rapamycin (mTOR) inhibitor used in combination with an aromatase inhibitor to treat advanced breast cancer, but may lead to development of osteonecrosis of the jaw that has a similar clinical presentation from bisphosphonate therapy. Case description: This case report describes the clinical presentation and management of a postmenopausal woman who developed osteonecrosis of the jaw while on targeted therapy with everolimus after extraction of a mandibular molar tooth. Practical implications: As everolimus has recently been approved by the Food and Drug Administration in the treatment of advanced breast cancer, the dental and medical community must be aware that such new targeted therapies in breast cancer treatment are potential risk factors for development of osteonecrosis of the jaw.

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