Breast cancer treatment and osteoporosis

Being on Letrozole for a year put me into osteoporosis and I just started with Fosamax. My endocrinologist and oncologist agreed that I could start with the weekly pill, Fosamax as I was fearful of the even more side effects often experienced with Reclast, IV infusion. If Fosamax doesn't help (will repeat DEXA in one year) I will progress to Reclast. Fingers crossed - these meds are a struggle and I wouldn't be on them unless I was solidly in osteoporosis. xo

Hi
I have osteopenia with a fracture in my spine at my t7 I do reclast or otherwise known as zoledronic acid I will have my third infusion in June. I only have fatigue the first day that's it but my pharmacist told me drink two Gatorade the day before take two Tylenol the night of take one Gatorade in the morning and take two Tylenol in the morning get them to infuse the medication over 30 to 45 minutes more slow the better and I have not had any side effects I hope this helps. I also am about to start radiation for breast cancer dcis not too keen on it but we do what we have to do I know I will not take an AI or tamoxifen not worth the risk for me

I am pre diabetic. I was 70 years old when diagnosed with ER+ breast cancer and had had osteopenia for a number of years. At the first visit with my endocrinologist after my lumpectomy, I told him that I would be taking an aromatase inhibitor. He said that I should tell my oncologist to prescribe whatever drug was best for my cancer and he would take care of my bones. When I questioned him, he said that the drugs could lead to osteoporosis, but I would eventually need treatment anyway because bone density decreases as we age. I took anastrozole
for about 3 months, but was unable to continue due to severe side effects. After 3 years with no medication for my breast cancer or my bones, my bone density has remained the same and not progressed to osteoporosis.
Medications have different effects on our bodies. I’m glad to hear that you are doing well on anastrozole. I think that requesting an annual DEXA scan is advisable, so you can monitor your bone density.
I wish you best of luck.
Becky

Did you decide to go with Zometa? I just started Fosamax and the ILC breast cancer meds, Letrozole put me into osteoporosis after only 1 year. I could have chosen IV infusion, Reclast but Fosamax seemed to have somewhat fewer side effects although I think not as easily absorbed.
Thanks for sharing! xo

So glad to read this and the reply. I went into Anastrozole with bone density test that said osteopenia. I was told that 5 yrs. was the max for anastrozole because of osteoporosis. I stopped at 3-1/2 months because of side effects. So glad I did. Osteoporosis is not on my personal agenda. Sara

Has anyone taken Anastrozole or other AI without taking a bisphosphonate and had no significant change in bone density? Could taking calcium and Vitamin D3 alone plus exercise maintain bone health?

It depends on your bone strength to begin with. I did lots of exercise for bone health, ate a calcium rich diet plus vitamin d. After 5 years on anastrozole I do have osteoporosis. Get your bones tested and talk to your doctor about a plan to move forward!

I've had a bone density test and have had osteopenia for quite a while.

That’s a really good question! I personally do not know anyone or have read any research on the percentage of people who DID NOT not get osteoporosis after 5 years of AI treatment. Especially for post menopausal women. I have a friend in her forties who who got Osteoporosis after 5 years on Tamoxifen. Asking Mayo Clinic, do you have any research or statistics? Thank you.

@petal, that's a very good question. Aromatase inhibitors are known to cause a loss of bone density, which can lead to osteoporosis and bone fractures. Studies may not show the numbers you are looking for. But you could search for rates of incidence per side effect. For example see this review:

Amir E, Seruga B, Niraula S, Carlsson L, Ocaña A. Toxicity of adjuvant endocrine therapy in postmenopausal breast cancer patients: a systematic review and meta-analysis. J Natl Cancer Inst. 103(17):1299-309, 2011. https://pubmed.ncbi.nlm.nih.gov/21743022/