Should all adjuvant breast cancer patients receive a bisphosphonate?

This commentary discusses the report by Trevor Powles and colleagues on their double-blind, placebo-controlled randomised trial of 2 years' adjuvant oral clodronate. Although the reported survival benefit in the clodronate-treated group confirms the results of one prior study as well as the generally held view that bisphosphonates could be advantageous, the reviewer does not feel that the data support the universal use of this additional adjuvant therapy.