Just want to say that if tamoxifen doesn't work out, or you get a second opinion favoring aromatase inhibitors rather than tamoxifen, I did 5 years of letrozole with a baseline osteoporosis that was hardly mild. I was unable to take Reclast during my treatment due to another health condition.

None of my oncologists suggested tamoxifen despite my relatively severe DEXA scan, so I was interested to read your doc's recommendation.

My bone density did drop the first year of letrozole, similar to the first year of menopause, and then the rate of loss steadied. I am on Tymlos now and doing well, though I did end up fracturing 18 months ago due to an unwise movement (after cancer meds and before Tymlos).