Breast cancer treatment and osteoporosis

My bones worsened on aromatase inhibitors so I cannot comment on the consequences of TNBC treatment like yours.

I do suggest a bone builder like Tymlos, Forteo or Evenity before doing a bisphosphonate (Reclast. Zometa, Fosamax etc.) or Prolia. I did Tymlos because the dose was adjustable, and am now doing Evenity before locking in gains with Reclast.

Cancer docs may suggest Reclast or Zometa though. There is some info on possible preventative effects with cancer that I cannot confirm but your docs can comment on that.

I have visited 5 different docs now all have insisted on biophophates Reclast being the most recommended The last endocrinologist said no to bone builders because I had radiation. Was that an absolute no for you? Did you not have radiation? Did you. have to go against his advice to use Tymloos?
I’m scared either way
jas

You didn't mention radiation in your first post. Others have said (and google says!) that may mean no Tymlos or Forteo. Can you do Evenity? Reclast is most often used during hormonal cancer treatment.

I only know the bone effects of estrogen deprivation from an aromatase inhibitor. It seems possible that your treatments may have affected estrogen levels-? Does your doctor confirm that?

If your bones get worse, perhaps you can do Evenity at some point?

I'm sorry you have the osteoporosis Osteoporosis issue too. I had one TNBC stage 1a tumor and one ER+PR+ Her2- stage 1a tumor in the other breast diagnosed 12/22 at age 70. I had a low Ki67 or 5%. I also have osteoporosis. Went to Mayo Rochester for treatment. Double mastectomy, clear margins, no node involvement. No chemo, on Tamoxifen even tho I am way past menopause for the ER+ because Tamoxifen builds bone. I also receive Zometa infusions for the osteoporosis 2x a year for 3 years. The Mayo Oncologist told me that Zometa can help to avoid recurrence in breast cancer patients and that why they give Zometa. He said studies show that women who have had breast cancer and have been on Zometa have a higher 10 year survival rate. So I thought great! I'll take that. I am exercising, eating 7-9 fruits and vegs a day and avoiding alcohol and processed meats as I was told these things would help to avoid recurrence. That info is from the Breast Cancer Survivorship area at Mayo. Sending Love and healing wishes to you and all on this site❤️

Just to be clear: Reclast and Zometa are both zoledronic acid.

I wish my doc had put me on one or the other. The doc's fears of effect on afib were unfounded. The only positive is that Tymlos had an intensely positive effect on my bones. But I missed out on that extra protection for recurrence. Nine years out, I am going on Reclast soon.

You are doing really well Windyshores! Yes I think Reclast and Zometa are the same drug but might there be a little something different about Zometa? I have no idea, I just know that Zometa is what the Mayo Oncologist has me on. Worth checking out to see if there may be some added benefit to that one. I always like to see your posts Windyshores, you are very knowledgeable about issues, you have many helpful things to say and reading that you are 9 years out is very encouraging!😍

Happen to me too First Osteopenia and then after chemo and radiation it became osteoporosis- but it runs on my family too. I am now taking Anastrozole and Prolia. I have back and hip / muscle pain especially after receiving the Prolia. It goes away after 3-4 month but then it is time to get the next shot. So I try to spread the injection out a little bit more . Hitting the 2 years mark in October and will have at that time another Scan. Hope that it helped. My Oncologist recommended to walk „as much as you can“ daily. So that what I do now. Some days are better than others. Hope you doing well.

To get off Prolia, you have to do Reclast or other bisphosphonate. Infusionslike Reclast are the most potent for preventing the awful rebound and increase in fracture risk when Prolia is stopped.

Zometa is 4mg and Reclast is 5mg. It seems Reclast is used for osteoporosis but Zometa is often used for cancer, but that is just a general impression from looking online.

Reading your post in regard of Prolia - my oncologist said nothing about all the side effects when I get off it . I am taking Anastrozole but now have osteoporosis- that why I got two Prolia injections and am due for the third one in May.
Question is should I ask to get Tamoxifen for the bones?