Bone Density Results
My MO ordered a bone density scan to establish a baseline before starting anastrazole. I had never had one and I was shocked when the results indicated osteoporosis (T-scores ranging from -2.7 to -3.6). Now I am a little freaked out. How bad are those scores for a 58yo? Is anastrazole a bad idea? What should I do to help my bone density?
Comments
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Magnoliachild,
A T score of -2.5 or lower is considered osteoporosis. I too have osteoporosis and have been able to increase the bone density in my hips with a serious walking program. I believe that building bone in the spine is more difficult. That being said, it’s likely that your doctor will talk with you about taking medication in addition to calcium and vitamin d to help maintain your bone density.
Aromatase inhibitors like Anastrozole are known to be hard on your bones. Since I am post menopausal with osteoporosis, my MO decided to put me on Tamoxifen instead of an AI as Tamoxifen actually helps maintain bone health. I was also started on Fosamax along with calcium and vitamin D. They are monitoring my bone density and will determine whether or not I can switch to an AI for my last 2 years of treatment. If not, I’ll just continue on Tamoxifen.
I am assuming that your doctor indicated that they would have you take Anastrozole prior to getting your bone density results? One way or another it’s definitely worth having a conversation about whether or not it’s still the best medication for you. Good luck!
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Magnoliachild, As mom2bill said, tamoxifen would be a better option. Since your osteoporosis is not caused by breast cancer treatment you might want to consult an endocrinologist or your PCP to treat it. My endocrinologist has me on Fosamax because it is the quickest drug to get out of your system if you need invasive dental work like a tooth extraction or implant. She also checks how well my bones are responding by doing periodic n-telopeptide urine tests between DEXA scans. Since overuse of drugs that improve bone density can cause problems including spontaneous fractures she has me cycle in and out of treatment to try to prevent this from happening in the future. She knows a great deal about estrogen but she leaves endocrine therapy to the oncologists since that that is their speciality and treats osteoporosis, diabetes and thyroid problems which are hers. It's good that the osteoporosis was discovered before you fractured a bone.
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I'd recommend seeing an endocrinologist who specializes in bone issues. He/she could also run some other tests, such as bone marker test, to get a sense of the current rate of loss. A few years after menopause, most women have a steeper rate of loss and then the loss slows.
T-scores compare your density to that of a typical 30-year-old, so they always look bad. Z-scores compare your density to other women your age. I'm 58 and my hips are pretty bad. My spine is closer to normal for my age.
I had taken tamoxifen for about 9 years and monitored my bones every 2 years since 46, when I was Dx'd with BC. (I have a rare bone condition and osteoporosis is common). In my case, I found that my spine was stabilized using tamoxifen, especially after menopause. The hips, not so much. Unfortunately, based on my research, it seems like a lot of meds help the spine density more than the hips.
I don't want to take the osteoporosis drugs, in part, because I'm not sure if they will work with my bone mutation. So I'm doing everything I can otherwise: calcium, Vit D, Vit K2, magnesium, boron (some people here have advocated eating prunes, and I tried for awhile but they give me gas); getting phytoestrogens in soy and flax seed; weight bearing exercise, including seeing a physical therapist whose helping me adjust my gait. I'm also starting collagen and using a vibration platform (see my other posts). I can't promise any/all of these will help but I'm trying all I can.
Good luck. If you feel like sharing, I'd be curious to hear how things go.
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My MO has ordered a Zometa infusion for me every 6 months. Has anyone had experiences with that?
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