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Topic: Postmenopausal, Osteopenic, Refused AI and Taking SERM Instead?

Forum: Bone Health and Bone Loss —

Talk with others about bone density, osteopenia and osteoporosis, and ways to keep your bones strong

Posted on: May 29, 2013 02:38PM

corky60 wrote:

My MO wants me to start Aromasin in August even though I'm osteopenic with a family history of osteoporosis. Ovaries were removed decades ago. Anyone else in similar situation and taking tamoxifen or Evista instead?

Dx 3/25/2013, IDC, Right, <1cm, Stage IA, Grade 1, 0/1 nodes, ER+/PR+, HER2- Surgery 4/25/2013 Lumpectomy: Right; Lymph node removal: Right Radiation Therapy 5/28/2013 Breast
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May 29, 2013 04:27PM MelissaDallas wrote:

Hi Corky. I'm still in the "thinking about it" stage, but I have just been offered Aromasin as I can't take Tamox or Evista because of a prior PE. Losing bone mass is the main reason I am leaning towards not taking it & just keeping up with my high-risk surveillance. I live alone and a major bone break would force me to have to stay with my sister or parents. I don't want to have to start yet another med to maintain my bone either.

LCIS, extensive sclerosing adenosis, TAH/BSO & partial omentectomy for mucinous borderline ovarian tumor.
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Jun 20, 2013 07:43PM micronancy wrote:

My MO wanted to put me on an AI because I'm 30+yrs post menopausal ( natural menopause at 36). Because my DEXA showed osteoporosis, I asked for Tamoxifen and Fosamax for at least 2 yrs to help my bones, and she agreed.

66 at diagnosis Oncotype 13 Dx 1/2013, IDC, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2- Surgery 2/3/2013 Lumpectomy: Left; Lymph node removal: Left, Sentinel
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Jun 20, 2013 07:56PM SpecialK wrote:

Just had this conversation with my MO today - I was osteopenic prior to BC diagnosis, post-meno (surgical) for 12 years.  Chemo and 6 months of Femara caused measurable loss after 9 years of being stable.  Started Prolia injections every 6 months and have had three so far.  Will repeat DEXA scan in 6 months, right after Prolia #4.  We chatted today about the possibility of Tamoxifen if I show any additional loss after having been on an AI for the intervening year.

BMX w/ TE 11/1/10, ALND 12/6/10. 15 additional surgeries. TCHx6 2/17-6/2/11. Herceptin until 1/19/12. Femara 8/1/11, Arimidex 6/20/12, back to Femara 6/18/13-present. Dx 9/27/2010, DCIS, Stage 0, Grade 3 Dx 9/27/2010, IDC, Right, 2cm, Stage IIB, Grade 3, 2/14 nodes, ER+/PR+, HER2+ (IHC)
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Jun 20, 2013 08:13PM - edited Jun 20, 2013 08:19PM by mom2twins34

I have pretty severe osteopenia (probably osteoporosis now because I was on the cusp of this a year ago and have been losing bone mass at a significant rate). I had been taking tamoxifen (since the age of 34) for two years when I had to go in for a radical hysterectomy in March of last year.

Of course I went through immediate surgical menopause and thought this would mean I would be switched to an AI.

But all 3 of my oncologists (1 Hospital MO and 1 Cancer Center MO and 1 RO -- 3 different people who don't always agree on things!) decided separately that I should stay on Tamoxifen for the full 5 years even though I should no longer be producing estrogen. I didn't "get" this decision, but they all stand by it. They feel that rather than moving over, 5 years of Tamoxifen plus 5 years on an AI will give me the most cancer benefit.
I'm still not sure I agree with the logic, but I figure that if these 3 are in agreement, then Tamoxifen must be an acceptable option for some postmenopausal women... :-)

Blog: Diag. 4/2010, IDC, IIIc, Gr. 3, Posit. lymph nodes w/extracaps ext., Supraclav node+, er/pr+, Her2+, Neoadj chemo (DD A&C, Taxol), BMX, more chemo, rads, hyst/ooph (masses), herceptin, tamox, Zometa
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Jun 20, 2013 09:01PM Jeannie57 wrote:

I started Tamoxifen in March and I'm post-menopausal. It is solely because I have osteopenia. My MO wants me to switch to an AI in a couple years to complete the ten years. I have very few SE's on Tamoxifen. I'm not looking forward to an AI.

Dx 1/27/2012, ILC, 2cm, Stage IIB, Grade 2, 3/39 nodes, ER+/PR+, HER2- Surgery 2/15/2012 Lumpectomy: Right; Lymph node removal: Right, Sentinel Surgery 3/29/2012 Lymph node removal: Right; Mastectomy: Right Surgery 3/29/2012 Lymph node removal: Left, Sentinel; Mastectomy: Left; Prophylactic mastectomy: Left Chemotherapy 5/25/2012 CMF Radiation Therapy 9/5/2012 Breast, Lymph nodes Hormonal Therapy 3/15/2013 Surgery 7/18/2013 Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Jun 21, 2013 02:48PM ICanDoThis wrote:

I had significant osteopenia before menopause (turned out I had hyperparathyroidism - 10 weeks out of surgery now) - was diagnosed with BC right after menopause. I refused AI, my onc and I agreed to tamoxifen for 2.5 years. She wanted me to switch to Femara, said that was optimal.
I thought about it for a long time -- I had a grade 1 tumor (good), 1.5 cm (meh...), low Kph (good), docs didn't go for oncotype, as none of them even considered chemo, huge margins, little to no DCIS -- and decided not to go for any more hormonal therapy.

If any of my factors had been slightly less positive, I probably wouldn't have decided that way, but as it was, 2 years later, I am comfortable with that decision

Sue - Proud to be Krista's Mom Dx 12/28/2007, IDC, Left, 1cm, Stage IA, Grade 1, 0/3 nodes, ER+/PR+, HER2- (FISH)
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Jun 26, 2013 05:49AM Golden01 wrote:

My MO originally recommended AI first then Tamoxifen. After a second opinion, we're going with Tamoxifen first for 2.5 years (for time to "work on my bones" - lots of dairy, getting my Vit D levels up, exercise) and then will switch to the AI for another 2.5 years. We'll see then about continuing either one longer. I really worry about osteoporosis. I broke a bone in my foot last fall (overuse, went back to walking and hiking too fast after a break of a few weeks) and it really set me back on exercise and getting my weight down. 

Mucinous Carcinoma, Hypercellular Variant; Oncotype DX 27, Dx 7/8/2011, <1cm, Stage I, Grade 2, 0/3 nodes, ER+/PR-, HER2- Hormonal Therapy 7/20/2014 Arimidex (anastrozole)
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Jul 12, 2013 03:44AM Member_of_the_Club wrote:

You can absolutely take tamoxifen instead.  My onc says that the benefit of an AI over tamoxifen is extremely minimal so if there's any reason to take tamoxifen instead there's no reason not to.

Dx 9/30/2004, IDC, 3cm, Stage IIB, Grade 2, 1/17 nodes, ER+/PR+, HER2-

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