Zoledronate or Observation in Maintaining Bone Mineral Density in Patients Who Are Undergoing Surgery to Remove Both Ovaries

Inclusion Criteria:

* Patients who have elected to undergo, or who have undergone (within 8 weeks) a surgical procedure that results (at minimum) in the absence of both ovaries

  * Patients enrolled in the screening arm of GOG-0199 who decide to undergo surgery are potentially eligible for GOG-0215
* Baseline bone mass density (BMD) T-Score ? -1.5 (no more than 1.5 standard deviation below the mean value for young adults) on both the total lumbar spine (L1-L4 region, not individual bones) and bilateral hip
* Patients who had/have at least 1 intact ovary at the time of surgery are eligible
* No prior distant metastatic malignant disease within the past 5 years

  * Patients treated for stage M1 (any T, any N) diagnosis in the past 5 years are ineligible
  * Patients who achieved a complete response after treatment for rM0 (any T, any N) within the past 5 years are eligible
* Premenopausal\*

  * Last menstrual cycle occurred \< 12 months prior to study enrollment
* GOG performance status 0-2
* Creatinine clearance \> 60 mL/min
* No clinical or radiological evidence of existing fracture of the lumbar spine or bilateral hip
* No history of hip of spine fracture with low-intensity trauma or not associated with trauma
* No uncontrolled seizure disorder associated with falls
* No diseases that influence bone metabolism, including any of the following:

  * Paget?s disease
  * Osteogenesis imperfecta
  * Uncontrolled thyroid or parathyroid dysfunction within 12 months prior to study entry
* No other nonmalignant systemic disease, including any of the following:

  * Uncontrolled infection
  * Uncontrolled type 2 diabetes mellitus
  * Cardiovascular, renal, hepatic, or lung disease that would prevent prolonged follow-up

    * History of thrombosis or thromboembolism allowed
* No known HIV positivity
* No known hypersensitivity to zoledronate or other bisphosphonates
* No psychiatric, psychological, or other conditions that prevent fully informed consent
* No other active malignancy except nonmelanoma skin cancer
* No history of any medical condition that places the patient at risk for donating blood for research purposes (e.g., chronic infectious diseases, sever anemia, or hemophilia)
* Not pregnant
* Negative pregnancy test
* No current active dental problems, including any of the following:

  * Infection of the teeth or jawbone (maxilla or mandible)
  * Dental or fixture trauma
  * Current or prior diagnosis of osteonecrosis of the jaw
  * Exposed bone in the mouth
  * Slow healing after dental procedures
* No recent (within 6 weeks) or planned dental or jaw surgery (e.g., extraction or implants)
* No prior treatment for osteoporosis
* No adjuvant radiotherapy within the past 31 days
* No chemotherapy within the past 30 days
* No prior surgery to the hip or spine
* No prior systemic sodium fluoride for \> 3 months during the past 2 years
* No more than 30 days use in the past 12 months and no concurrent tamoxifen, raloxifene, or any other selective estrogen-receptor modulator (SERM)
* More than 12 months since prior and no concurrent endocrine therapy

  * Insulin and/or oral antidiabetic medications allowed
  * Thyroid hormone replacement allowed
* More than 12 months since prior and no concurrent estrogen or hormone replacement therapy (estrogen plus progesterone or estrogen alone)

  * Prior or concurrent oral contraceptives allowed
  * Systemic (oral) hormone replacement therapy following surgery not allowed

    * Vaginal (non-systemic) estrogen allowed
* More than 12 months since prior and no concurrent oral or IV bisphosphonate
* More than 12 months since prior and no concurrent anabolic steroids or growth hormone
* More than 12 months since prior and no concurrent systemic corticosteroids

  * Concurrent short term corticosteroid therapy (to prevent/treat chemotherapy-induced nausea/vomiting) allowed
* More than 6 months since prior and no concurrent Tibolone
* More than 2 weeks since prior and no concurrent drugs known to affect the skeleton (e.g., calcitonin, mithramycin, or gallium nitrate)
* No concurrent chemotherapy or radiotherapy
* No concurrent aromatase inhibitors
* Concurrent enrollment on protocol GOG-0199 allowed