Bone metastases (BM) are a common finding in breast cancer patients. Approximately 25% of breast cancers spread first to the bone. The majority of the bone lesions are osteolytic. Osteoclast activation via tumor-derived growth factors and cytokines play an important role in osteolytic BM in breast cancer patients. Pain, hypercalcemia and bone fractures are common complications of BM. Chemotherapy, hormonotherapy, surgery, and radiotherapy are used with palliative intent for management of breast cancer patients with BM. Additionally, bisphosphonate treatments may reduce the incidence and severity of skeletal complications. We review herein the role of bisphosphonate use in the management of breast cancer with BM.