Hi sue417--my bone density was just fine going in, and I intend to start having it checked. You might ask your oncologist to explain how much tamoxifen will reduce the risk or recurrence, and if it extends life expectancy. This really can vary case by case. I have fibromyalgia-like chronic pain. Keeping this under control is probably my highest priority. I've had no ill effect from letrozole, but ave never been on tamoxifen. Check in and tell us what you decide to do and how it is going. It's hard to juggle all this--but I tell myself so far so good!