Breast cancer treatment with osteopenia: What's your experience?

Tamoxifen isn't a problem for bones. Aromatase inhibitors can be, though Reclast (zoledronic acid) helps with that.

Well that's good to know. I know I will only do 10mg as I am super hypersensitive to medication

Here are some related discussions:
- Zoledronic Acid: I need feed back for this drug please
https://connect.mayoclinic.org/discussion/need-feed-back-for-this-drug-please/
- What exercise if safe and good for bone health with osteoporosis?
https://connect.mayoclinic.org/discussion/osteopososis-and-safe-exercise/
- Zometa infusions to help prevent bone loss from cancer treatments
https://connect.mayoclinic.org/discussion/zometa-infusions/
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@sue417, with a spinal fracture, do you have ostopenia or osteoporosis?

Hi
I have osteopenia, I do zoledronic acid . This yr will be my 3rd injection. My bone density improved greatly in my spine but not in my hips

I had a gynecologist who had me get bone scans in 2017 and 2019. My first bone scan showed my bone density to be -1.4T. (osteopaenia)
I was diagnosed with breast cancer (right side) on 12/7/2021 and had a lumpectomy on 1/27/2022. I had had a biopsy in 2018 that showed benign calcification, but this was 3 years later.
Following the lumpectomy, I was (belatedly) given another bone scan in late May of 2022, although Medicare initially refused to pay for it, for reasons I have never understood. (It took until March of 2023 to get it straightened out and the most likely explanation I have heard is that the oncologist's office coded it incorrectly).
My bone density in 2022 was -2.2T (where osteoporosis is supposed to start at -2.4T, according to my endocrinologist's office, as I also doctor for Type II diabetes and have been a patient at the Texas Diabetes & Oncology Center since 2017).
I voluntarily had 33 radiation sessions. On Feb. 1 when showed up at the oncologist's office to be seen I had a fever of 102 and had to take 500 mg. of Cephalexan every 4 hours for weeks to heal up from that. I had an ultra scan on the one-year anniversary of surgery (1/27/2023) and it said I needed to be seen by an oncologist, so I began doctoring here in Austin (Tx) where we winter.
I was given pills by the endocrinologist's office when I inquired, but, after reading about them, did not take them. I am now involved in getting a dental implant and one of the questions asked a lot on the paperwork was about biophosphates. I hope the implant goes well. I go back on 1/31 to see how it is healing. It was the second of my teeth to be killed during a routine cleaning. (This one, the #4 tooth, split way below the gum line).
I honestly am becoming paranoid about having my teeth cleaned, as I've now lost 2 teeth to a routine procedure. I'm also confused about what I've read about DEXA scans, as some suggest they aren't too precise and the readings can be affected.

Hi
Well that's quite an ordeal ypu have been thru. The year my spine fractured I had 3 teeth fracture within 1 mth, that was prior to being diagnosed with osteopenia or any bisphosphonate. I had to get 3 crowns. My last cleaning went well so fingers crossed.

@einnoc sorry for what you have gone through. In my experience there is variation in DEXA results but you get a good ballpark idea of where you are and watching trends is important. It seems safe to say that you still have osteopenia but on the lower end. The cut-off for osteoporosis is -2.5, I have been told. Of course it is a continuum not a point! At that level I don't think osteopenia would cause the dental issues. My scores are way worse and no dental issues!

It sounds like your endocrinologist gave you Fosamax (pills). With your scores, many docs would not prescribe meds yet. They would say to make sure to get calcium and Vitamin D in sufficient amounts, and do weight bearing exercise (walking is fine).

Did your latest ultrasound show cancer or precancer? Why were you referred to an oncologist? And did you do/are you doing an aromatase inhibitor for your cancer? Those can cause bone loss over time. Most of us are prescribed Reclast (a bisphosphonate) to combat that. Maybe that is why your endo prescribed Fosamax, also a bisphosphonate.

I had 3 compression fractures (and osteoporosis) just about the same time as I was diagnosed with breast cancer at 70 years old last year. I went to Mayo for treatment. I was put on Tamoxifen even tho I am way past menopause because it is better for your bones than aromatase inhibitors. AIs can deplete the calcium from your bones. I am on Zometa infusions now 2x a year for 3 years for the osteoporosis and they have found Zometa has the added benefit of helping to avoid recurrence in the bones. Sending love and healing wishes to you and all on Connect❤️

I had a t12 fracture 2022 due to I fell from passing out from coughing from the flu before the doctor could see me. Later that year, I had bone scan & was diagnosed with ostopenia by my pcp. Last year I had breast cancer, surgery & radiation. However, I saw an arthritis specialist who says due to my fracture from a fall, she would diagnose me with osteoporosis. My pcp goes strictly by the scan & says no, so I am only taking vitamins & calcium supplement. After reading some of the side effects of osteoporosis meds, I’m not upset at that as I take enough meds for other issues. Wishing you all the best!!

@dp77827 it sounds like that fall may have been "traumatic" nojt "osteoporotic" or at least a combo of the two.

People with osteopenia account for the highest number of fractures overall. People with osteoporosis have the highest rate of fractures. So having a fracture should not mean you have osteoporosis, necessarily- according to my experience as well as what I have read.

That said, if you do develop osteoporosis at some point, the fracture will mean you can have access to bone building drugs which are not usually easily covered by insurance. Generally insurance requires bisphosphonates or Prolia first but it is much better to start with bone builders like Forteo, Tymlos or Evenity. So keep that info under your hat!

My first fracture was also T12 and also from a fall. It changed my ability to lift things. How are you now?