INTRODUCTION
Breast cancer is the most diagnosed cancer in women. More than 271270 new cases were diagnosed in the United States in 2019, resulting in more than 42260 deaths.1 The development of breast cancer is further complicated by the disease's high metastatic potential. Up to 70%of women diagnosed with breast cancer will develop metastatic bone disease.2 The skeleton is the largest tumor reservoir in the body, allowing both tumor recurrence and the development of tumor-related skeletal events such as local bone destruction, debilitating bone pain, pathologic fractures, compression of neurovascular bundles, and paralysis. These sequelae increase disease-related morbidity and mortality.