The first reported case of Atypical Femoral Fracture caused by daily ibandronate prescribed for bone metastases in breast cancer

• Published in: BMJ case reports Vol. 2017; p. bcr-2016-217489
• Main Authors: Espey, Robert, Grimes, Stephanie, Heyburn, Gary, Kealey, William David
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 09.05.2017; BMJ Case Reports
• Series: Case Report
• Subjects: Administration, Oral; Bone Density Conservation Agents - administration & dosage; Bone Density Conservation Agents - adverse effects; Bone Nails; Bone Neoplasms - drug therapy; Bone Neoplasms - secondary; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - secondary; Cancer therapies; Diagnosis, Differential; Diphosphonates - administration & dosage; Diphosphonates - adverse effects; Family medical history; Female; Femoral Fractures - chemically induced; Femoral Fractures - diagnosis; Femoral Fractures - diagnostic imaging; Femoral Fractures - surgery; Humans; Ibandronic Acid; Metastasis; Middle Aged; Oncology; Osteoporosis; Pain; Patients; Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions; United Kingdom; White; orthopaedic and trauma surgery; oncology; pharmacology and therapeutics
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2016-217489

A 55-year-old woman with bony metastatic breast cancer was commenced on daily ibandronic acid to prevent skeletal related events (SREs). Four years later, she began to experience new lower limb and groin pain with investigations leading to the suspicion of further metastatic spread to her left femur. While awaiting radiotherapy for this, she unfortunately tripped and fell sustaining a fracture to the proximal third of her left femur. Radiographic findings of her femur from both before and after the fall were suggestive of an atypical femoral fracture, presumed secondary to her bisphosphonate therapy rather than metastatic spread.