@ppat4pr and @mariegroh this article is actually very reassuring about osteonecrosis of the jaw and Fosamax, so I hope folks read it.

Just want to add that I recently posted a study that said the incidence of osteonecrosis of the jaw is one in ten thousand for the usual dose. For stage 4 cancer patients with metastasis to the bones, the statistic is one in ten. The risk is less with oral meds like Fosamax versus injected Reclast or Zometa.

My doc says most cases are among stage 4 metastatic cancer patients who take larger doses (Zometa usually). Many other patients seem to be taking Reclast or Fosamax or other biphosphonates for more than 10 years, which would increase risk.

I did not take a biphosphonate with letrozole and ended up with three new spinal fractures. My bones got much worse without. I didn't decline the drug. I was unable to take it and my doc did not want me to try again because at the time it was thought to exacerbate my afib.

I wish I could have taken it!

@ppat4pr everyone on here wants to help and the warning from @mariegroh is something to keep in mind long term. But it should not scare you in terms of 5 years on Fosamax to counteract the very real risk to bones while on letrozole. (I am assuming you are not stage 4 but would say the same even if you are....)