Introduction-Objective: Breast cancer ranks as the second most common cancer worldwide, following lung cancer, and is the most prevalent cancer type among women. Among the reasons for breast cancer-related deaths, breast cancer cells' high metastatic potential, primarily targeting the lungs, liver, and bones, plays a crucial role compared to other cancer types. Bone metastasis, driven by metastatic cells, stimulates osteoclast-mediated bone resorption, leading to osteolysis, fragility, and susceptibility to fractures in bones. Bisphosphonates, with Zoledronic acid among them, are inhibitors of osteoclast-mediated bone resorption, and therefore, they are clinically employed in the treatment of bone diseases, postmenopausal osteoporosis, and cancer types with bone metastasis. The aim of this study is to assess the mandibular bone structure using Fractal Analysis (FA) in breast cancer patients using bisphosphonates. Materials and Methods: This retrospective study included orthopantomogram images of patients. Regions of interest (ROIs) were identified in three areas of the mandible. The geometric center of the area between the mandibular notch and mandibular foramen was defined as ROI-1, the geometric center at the junction of the mandibular corpus and mandibular ramus as ROI-2, and the region at the mesial of the mental foramen as ROI-3. Mann Whitney-U test was used for intergroup comparisons. Results: FA data obtained from a total of 48 female patients (24 with breast cancer and 24 age-matched control subjects) were included in this study. FA data for ROI-1, ROI-2, and ROI-3 were higher in breast cancer patients compared to the control group. Discussion-Conclusion: Higher FA values indicate a complex trabecular structure and high bone trabecular density. Attention should be paid to the mandibular bone structure in breast cancer patients.