@soggybones It's a close call whether I've spent more time researching my breast cancer or bone health. I think my breast cancer treatment options have been less complicated.

I was diagnosed with estrogen positive breast cancer in the fall of 2024 and treatment with surgery, chemo, and drugs following 2025 through now. The drugs included the aromatase inhibitor, letrozole and kisqali.

Although my most recent Dexa scan in August 2025 showed I was holding an osteopenia diagnosis with some slight improvement, my oncologist wanted me on an osteoporosis medication because of a higher FRAX score on my Dexa, my age which was 74 then, and being on letrozole.

Although I wanted to start with an anabolic osteoporosis drug, 2 endocrinologists I saw both ruled that out because my breast cancer was estrogen positive. HRT was an obvious no, alas. Boy, do I wish I'd been on bioidentical HRT before my breast cancer diagnosis.

I cannot tolerate bisphosphonates you swallow because of a history of reflux and I refused to start Prolia because of its potential complications. That left the more powerful and risky Reclast or Zometa which are both zoledronic acid but with different dosages.

I had my first Zometa infusion October 2025. Although my oncologist recommended another infusion in 6 months, I am waiting for at least one year until the next one.

There is breast cancer research looking at alternative drugs to aromatase inhibitor. These are now in clinical trials. One such drug is giredestrant which is a drug category called SERD or selective estrogen receptor downregulator. One more acronym to learn! I don't know much about it but my hope is that it has fewer side effects than aromatase inhibitors including it's detrimental affect on bones. What, if any, other side effects SERDs may have, however, is another question as is how long before such drugs are fully FDA approved.

@soggybones I hear you! I listened to a podcast interviewing Dr. Belinda Beck out of Australia. Her Onero program sounds like a solid researched based plan for safely building back bone density. I’m going for an eval with a local PT this week. The Onero website has a map of locations across the US that offer this program. You can see more about it from others here:https://connect.mayoclinic.org/discussion/onero-program-for-bone-building/. Blessings to you as we get stronger through sharing resources! You are not alone!