{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T01:26:01Z","timestamp":1779326761347,"version":"3.51.4"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T00:00:00Z","timestamp":1711324800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T00:00:00Z","timestamp":1711324800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>As an oncologic emergency related to abnormalities in calcium metabolism, hypercalcemia associated with paraneoplastic syndrome and bone metastases is well known. Meanwhile, the incidence of hypocalcemia is low, except in cases associated with bone-modifying agents used for bone metastases. Hypocalcemia induced by bone-modifying agents typically occurs early after the initial administration, and its incidence can be significantly reduced by preventive administration of calcium and vitamin D3 supplements.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case report<\/jats:title>\n                <jats:p>We report two cases of recurrent severe hypocalcemia occurring during chemotherapy for metastatic breast cancer with multiple bone metastases.<\/jats:p>\n                <jats:p>Case 1: A 35-year-old Japanese woman developed metastases in the bone, liver, and ovaries during postoperative endocrine therapy for invasive lobular carcinoma of the breast. She underwent chemotherapy and treatment with denosumab. She experienced recurrent episodes of severe hypocalcemia subsequent to a change in the chemotherapy regimen. Case 2: A 65-year-old Japanese woman encountered multiple bone metastases after postoperative anti-human epidermal growth factor receptor 2 therapy and during endocrine therapy for invasive ductal carcinoma of the breast. She underwent anti-human epidermal growth factor receptor 2 therapy and treatment with denosumab. She experienced recurrent severe hypocalcemia subsequent to a change in the chemotherapy regimen to letrozole\u2009+\u2009lapatinib, trastuzumab emtansine, and lapatinib\u2009+\u2009capecitabine.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>We observed two cases of recurrent severe hypocalcemia in patients with advanced breast cancer and bone metastases after modifications to their therapy regimens. These cases differed from the typical hypocalcemia induced by bone-modifying agents. It is possible that antitumor drugs affect calcium and bone metabolism associated with bone metastases. While these cases are rare, it is crucial for oncologists to be aware of hypocalcemia not only at the initiation of bone-modifying agents but also throughout the entire antitumor therapy, as hypocalcemia can lead to fatal outcomes.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-024-04478-3","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T02:32:08Z","timestamp":1711333928000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Recurrent severe hypocalcemia following chemotherapy regimen changes in advanced breast cancer: two case reports"],"prefix":"10.1186","volume":"18","author":[{"given":"Yurina","family":"Yanase","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7361-3647","authenticated-orcid":false,"given":"Hiroko","family":"Bando","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riko","family":"Sato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohei","family":"Matsuo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aya","family":"Ueda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mai","family":"Okazaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sachie","family":"Hashimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akiko","family":"Iguchi-Manaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hisato","family":"Hara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,3,25]]},"reference":[{"key":"4478_CR1","doi-asserted-by":"publisher","first-page":"1039490","DOI":"10.3389\/fendo.2023.1039490","volume":"14","author":"A Elvina","year":"2023","unstructured":"Elvina A, Irfan C. Cancer-related hypercalcemia and potential treatments. Front Endocrinol. 2023;14:1039490. https:\/\/doi.org\/10.3389\/fendo.2023.1039490.","journal-title":"Front Endocrinol"},{"issue":"5","key":"4478_CR2","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1200\/JOP.2016.011155","volume":"12","author":"G Whitney","year":"2016","unstructured":"Whitney G. Cancer-related hypercalcemia. J Oncol Pract. 2016;12(5):426\u201332.","journal-title":"J Oncol Pract"},{"issue":"6","key":"4478_CR3","first-page":"231","volume":"74","author":"A Schattner","year":"2016","unstructured":"Schattner A, Dubin I, Huber R, Gelber M. Hypocalcaemia of malignancy. Neth J Med. 2016;74(6):231\u20139.","journal-title":"Neth J Med"},{"issue":"16","key":"4478_CR4","doi-asserted-by":"publisher","first-page":"3082","DOI":"10.1016\/j.ejca.2012.08.002","volume":"48","author":"A Lipton","year":"2012","unstructured":"Lipton A, Fizazi K, Stopeck AT, Henry DH, Brown JE, Yardley DA, et\u00a0al. 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A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"150"}}