Aromatase Inhibitors: Did you decide to go on them or not?

This occurred to me the other day... my DEXA fron 2021 shows very little difference when compared with one done in 2015. In fact my PCP twice compared them and the dates and said that they're nearly identical within a margin of error.

A friend suffered a broken mrck in 2015 and was hospitalized or in rehab for 2.5 years. When he was put in a halo contraption to hopefully enable bones pieces to reattach, I found the best 'bone formula' vitamin supplement that I could to keep him supplied with. I also started taking the stuff as it was on my kitchen counter.

I now ponder that the insignificant changes between the two DEXASCANs 6 years apart are attributable at least in part to the daily supplement. [The DEXA bone density decreased by hundredths of a percent in one case and increased by tenths of a percent in another.] At any rate, I'm continuing to take the stuff. An echocardiogram and calcium score test reassured my cardiologist and me that the calcium seems to not be building up in arteries as some people fear.

You only have osteopenia. I had osteoporosis for 14 years w/out fracture.

Thanks. I don't have pain beyond stiffness from four herniated disc's that, thankfully only infrequently, remind me that they are there. But apparently that's not proof of no problem

In my case, the radiation offered was a kind of post-surgery "clean up" of the excision area, and was usually done within 6 weeks of the surgery. The radiologist explained it as ...as if one had broken a glass and picked up all of the visible pieces already (the surgery). Then the radiation was analogous to vacuuming up any unseen tiny pieces.

It's not a bad idea but it only gives some extra protection to the tiny area of the excision. It does not affect the possibility of radiation anywhere else including elsewhere in the same breast. My two issues were that radiation in the left breast would be nearer the heart andcalways carries the increased risk of lymphedema. The protocol was for radiation every other day, five times.

But even the radiologist described it as an option rather than a stong suggestion. The second oncologist I saw said it's an option but he wouldn't have recommended it at the time given the post-surgical biopsy.

One never knows if all the decisions, in retrospect, turned out to look perfect in the rear view mirror :-). The thing is that, with cancer, the decisions can come so fast while one is still reeling from having found oneself in Cancerland in the first place. And trying to avoid the horror stories heard about other cancer patients' too-late regrets. I suspect many of us share that whirlpool of having to act fast, while thinking takes time.

So I found an interesting study that says basically that Oncotype does not correlate with benefit or no benefit from radiation, so @callalloo you may be right in saying that this needs to be corrected at breastcancer.org.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8285794/
2015
excerpt:
"Interestingly, radiation therapy was protective in patients with intermediate or low Oncotype DX scores but not in patients with high Oncotype DX scores (Table ​(Table2).2). In intermediate-risk patients, an HR of 0.72 (p = 1.5E−5) suggested that patients who underwent radiation therapy had longer OS compared to patients who did not undergo radiation therapy. Similarly, an HR of 0.76 (p = 2.0E−4) in low-risk patients suggested prolonged OS after the use of radiotherapy (Table ​(Table2).2). A similar observation was made when using BCSS although the association in low-risk patients did not reach statistical significance (Additional file 2 – Table 1)."

I should have had radiation afterall! Maybe you too!

Compression fractures can happen without any pain or symptoms. I have one I did not know about. My other fractures were/are extremely painful. Sometimes an x-ray for another reason will pick up a fracture.

Does a compression fracture always cause pain? That is, could one have compression, or othet, fractures in the vertebrae without having any symptoms?

I would think a PET/CT is in order to make sure there is no unusual cells in these fractures if that hasn’t already been done. Even with osteoporosis it seems like compression spinal fractures should be investigated further.

I'm just taking breastcancer.org's statement as written and pointing out that it is incorrect.

The OncotypeDX does not, in fact,
"predict(s) the likelihood of benefit from...radiation' therapy treatment" as stated in the excerpt you cited below. It does not make any radiation predictions at all.

"So, the Oncotype DX Breast Recurrence Score Test is both a prognostic test, since it provides more information about how likely (or unlikely) the breast cancer is to come back, and a predictive test, since it predicts the likelihood of benefit from chemotherapy or radiation therapy treatment. Studies have shown that Oncotype DX Breast Recurrence Score Test is useful for both purposes."

So your Oncotype score helped you decide against radiation. I think that is all that breastcancer.org is saying.