Bone-directed therapy (Denosumab and Bisphosphonate) for breast cancer is used in two major settings: As an adjuvant therapy after surgery to reduce the risk of cancer recurrence (Bisphosphonate only) In stage 4 disease when breast cancer has spread to bones Bone-directed therapy as an adjuvant therapy after surgery: Breast cancers can sometimes recur and spread to bones, usually many years after patients have had an …