Breast cancer treatment and osteoporosis

Posted by jknows @jknows, Feb 24, 2024

I was diagnosed with triple negative breast cancer in February 2023. I received the Keynote 522 protocol that includes chemo, surgery and immunotherapy. I just had a repeat bone density test and discovered I have moved from osteopenia to osteoporosis. Is this a common outcome from BC treatment and if so how is the osteoporosis treated?

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Profile picture for segm @semurrey

My endocrinologist never mentioned anything g but Fosamax or Reclast to start! He is very well respected at MGH-Boston so I wonder why he never mentioned the bone builders you mention?!!

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@semurrey I just found this discussion while looking for more information about Reclast for breast cancer patients. May try to post my specific question here but wanted to respond to your question since it's similar to my own.

I wonder if the reason your endocrinologist didn't recommend an anabolic bone builder like Forteo or Tymlos is because you have hormone-positive breast cancer. It seems there is concern about a potential risk to those who have estrogen-positive breast cancer. You can do a basic AI search and you'll find that concern mentioned.

I had my plan of action once my oncologist mentioned Reclast: Take an anabolic first and THEN follow with Reclast if necessary. When I mentioned that to my endocrinologist, she forcefully said no. She didn't explain why, and I was so busy asking other questions I forgot to press her about it. I came home and posted the question to AI and that's how I began to find information about anabolics and estrogen-positive breast cancer.

Regardless, I wish this information about sequencing of osteoporosis drugs specifically for breast cancer patients was more transparent. Different breast cancer diagnoses will give you different osteoporosis drug options and the reasons behind those should be explained

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Profile picture for prarysky @prarysky

@semurrey I just found this discussion while looking for more information about Reclast for breast cancer patients. May try to post my specific question here but wanted to respond to your question since it's similar to my own.

I wonder if the reason your endocrinologist didn't recommend an anabolic bone builder like Forteo or Tymlos is because you have hormone-positive breast cancer. It seems there is concern about a potential risk to those who have estrogen-positive breast cancer. You can do a basic AI search and you'll find that concern mentioned.

I had my plan of action once my oncologist mentioned Reclast: Take an anabolic first and THEN follow with Reclast if necessary. When I mentioned that to my endocrinologist, she forcefully said no. She didn't explain why, and I was so busy asking other questions I forgot to press her about it. I came home and posted the question to AI and that's how I began to find information about anabolics and estrogen-positive breast cancer.

Regardless, I wish this information about sequencing of osteoporosis drugs specifically for breast cancer patients was more transparent. Different breast cancer diagnoses will give you different osteoporosis drug options and the reasons behind those should be explained

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@prarysky Thanks so much for checking in - very helpful and much appreciated. I'm due for my third Reclast infusion in late October. There hasn't been discussion of what next steps would be after 6 Reclast infusions (twice a year) but I will have a DEXA in February (two years since last). I've been on Letrozole for invasive lobular cancer for 2.5 yrs which put me into osteoporosis and since I'll probably be on the letrozole for 8-10yrs I'm hoping this Reclast helps. Thanks again and I hope you are feeling well! xo

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Profile picture for segm @semurrey

@prarysky Thanks so much for checking in - very helpful and much appreciated. I'm due for my third Reclast infusion in late October. There hasn't been discussion of what next steps would be after 6 Reclast infusions (twice a year) but I will have a DEXA in February (two years since last). I've been on Letrozole for invasive lobular cancer for 2.5 yrs which put me into osteoporosis and since I'll probably be on the letrozole for 8-10yrs I'm hoping this Reclast helps. Thanks again and I hope you are feeling well! xo

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@semurrey It sounds as if you are doing well with the Reclast infusions. I hope you get some positive and encouraging results on your next DEXA. Yes, those aromatase inhibitors do not play nicely with our bones....sigh. It sounds as if you are handling the letrozole well too. I hope I have the same experience since, like you, the recommendation is for me to stay on letrozole for 10 years. Sending healing thoughts your way!

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