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Topic: Arimidex, osteopenia, and my MO

Forum: Bone Health and Bone Loss —

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

Posted on: Sep 3, 2021 12:38AM - edited Sep 3, 2021 12:40AM by NayaBean

NayaBean wrote:

At my first appointment with my MO on August 4, she prescribed Arimidex and also ordered a bone density scan. The scan results, which posted on MyChart recently, show that I have osteopenia. Clearly that's something that my MO and I should talk about at some point, but I'm not sure whether it is an urgent issue that needs to be discussed before my next appointment on November 3, or whether it can wait until then.

I thought I would have heard from my MO about the scan results when they became available, even if only in a MyChart message, but she has not reached out to me about that. I'm trying to decide if I should message her now about the scan results, especially considering that I am on Arimidex, or whether it is fine if I just sit tight and wait until our November 3 appointment to discuss this.

I ask about this here to get a sense of what the norm is in this situation. Would your MO reach out to you between appointments about something like the results of a bone density test? Or does waiting for the next appointment to talk about it seem like the normal course?

Dx 5/27/2021, IDC, Left, Stage IIA, Grade 3, 1/38 nodes, ER+/PR+, HER2- Surgery 6/25/2021 Lymph node removal: Left; Mastectomy: Left; Reconstruction (left): Tissue expander placement Hormonal Therapy 8/4/2021 Arimidex (anastrozole)
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Sep 3, 2021 12:44AM jhl wrote:

NayaBean,

In my experience, osteopenia is not an urgent issue and I feel can wait until your November appointment. However, in the meantime, you can take daily calcium with Vitamin D, which is probably what is recommended. Since you have a MyChart, you can send your MO a message & ask what measures you should take to prevent osteopenia from developing osteoporosis. Direct impact exercises, like walking, will also be helpful.

Stay well,

Jane

Dx 11/15/2019, IDC: Cribriform, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- (FISH)
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Sep 3, 2021 02:10AM - edited Sep 3, 2021 02:16AM by ShetlandPony

My onc would call with a PET or CT result since waiting to find out if there is progression or not is nerve-wracking. But for something like this, no, it is fine to talk about it at the next appointment. Arimidex and bone health is a long-term management and monitoring thing. Nothing is going to change quickly.

If you want to start taking any supplements a message to your onc would be appropriate. Mine recommended vitamin D3 but prefers calcium from food because there are heart health concerns with calcium supplements. She also okayed my idea to take magnesium, omega 3 fish oil, and K2. Your onc can order a blood test for vitamin D level, so if you ask for that in a message, you can have the results for your appointment. My onc also mentioned weight-bearing exercise.

2011 Stage I ITCs sn, premenopausal, Oncotype 16. 2014 Stage IV mets breast,liver. TaxolNEAD. Ibrance+letrozole 2yrs. Fas+afinitor nope. XelodaNEAD 2yrs. Eribulin,Doxil nope. SUMMIT FaslodexHerceptinNeratinib for Her2mut NEAD Dx 2011, ILC, 1cm, Stage IA, Grade 1, 0/1 nodes, ER+/PR+, HER2- Dx 2014, ILC, 2cm, Stage IV, metastasized to liver/other, Grade 2, ER+/PR+, HER2- Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy Whole-breast: Breast Surgery Lumpectomy
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Sep 3, 2021 06:22AM Sabbymama wrote:

Mine did not. She just discussed it with me at our next meeting and she recommended Zometa infusions every six months to prevent further deterioration of my bones. I had already been taking Vitamin D daily as my levels are extremely low and Calcium as well, but not every day. And as others have suggested, walking daily is an excellent idea especially since keeping active helps lessen some of the joint pain caused by the AIs. Good luck!

Cheers,

Sabbymama

Dx 3/2/2020, DCIS/IDC, Left, 6cm+, Stage IIIA, Grade 2, 4/22 nodes, ER+/PR+, HER2- (FISH) Surgery 4/9/2020 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy; Reconstruction (left): Tissue expander placement Chemotherapy 5/25/2020 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 9/13/2020 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 10/11/2020 Arimidex (anastrozole) Surgery 6/9/2021 Prophylactic mastectomy: Right
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Sep 3, 2021 08:13AM DebAL wrote:

agree with the others. Not an urgent issue. Treatment may depend on your score. I barely fall in the osteopenic category. So vit D, CA, exercise, resistance training etc Every 2 years is the standard for bone density tests. Good luck

Dx 1/22/2018, IDC, Left, <1cm, Stage IA, Grade 1, 0/3 nodes, ER+/PR-, HER2- (IHC) Surgery 2/12/2018 Mastectomy: Left, Right Surgery 2/12/2018 Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 4/2/2018 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 6/14/2018 Arimidex (anastrozole) Surgery 8/9/2018 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 12/20/2018 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting Surgery
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Sep 3, 2021 09:36AM ThreeTree wrote:

NayaBean - As with the others, my oncologist took the issue up with me at the appointment following the scan and didn't contact me when the results posted to MyChart. My scan showed osteoporosis and osteopenia. The oncologist recommended vitamin D and calcium. I take D3 with K2 for better absorption and I only maybe once a month take one of the calcium pills, because I read on many reputable sites that there are serious concerns about calcium supplements just sitting in and clogging up your arteries and heart; not really getting out to your bones, so I try to get calcium mostly from diet. My oncologist doesn't like any deviation from the "standard of care" recommendations she makes, but I do occasionally divert.

When I did see the oncologist, she suggested zometa, but I told her I'd rather watch and wait and she wasn't crazy about the idea, but she went with it. After a year, I had another scan that showed that after a year of letrozole, my results were essentially the same as when I started, so I continue to watch and wait, as I have real fears of bisphosphonates and their effects. I started eating dried plums (6 to be exact) every day, as they have been shown to increase bone density. I also work in about 2-5 tablespoons of extra virgin first cold pressed olive oil to my food every day,k along with taking the D and increasing dietary calcium, because that too has shown some promise with bone density. I think that might have been some of the reason my bones stayed the same during the first year of AI treatment, and I'm banking on the same for this next year and beyond. Ruthbru, who posts on here did all 5 years of the AI and ate the serving of prunes every day and her bones never got worse than whatever they were to begin with. She was also not interested in bisphosphonates. That's what I'm hoping for; same or better, just not worse.

You are not in an urgent situation, so I would recommend just waiting until your next appointment.

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Sep 4, 2021 03:33PM typhoon wrote:

NayaBean - My experience has been similar to those of all the other folks who have chimed in. When she prescribed Arimidex, my onc also sent me for a bone density scan; turns out I was just over the line into osteoporosis, and my next appointment with the onc wasn't for a couple of months. What I *did* do was talk to my GP and get recommendations for supplements (I've added D3 and B12 to my daily multi-vitamin), and then sent a message through the patient portal, to the BC-specialist RN who is my primary POC in my oncologist's office, that I was adding the supplements. At the next appointment, my onc prescribed Zometa infusions every six months, for three years; I recently had my second infusion, with no issues so far, and all my blood work has been great. My onc also set me up with the nutritionist who works in her practice, to go over my diet and make sure I was doing everything sensible food-wise to maintain bone health.

So, it's not an urgent situation, and you can definitely wait for your next appointment. But there are some things you can do - supplements, dietary changes if necessary - in the meantime. Messaging your oncologist to advise what supplements you are adding is definitely a good thing to do, as well. Good luck!!


Dx 10/23/2020, DCIS/IDC, Both breasts, <1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2- (IHC) Surgery 12/9/2020 Lymph node removal: Left, Right, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy 1/14/2021 Arimidex (anastrozole)
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Sep 7, 2021 10:55PM lexie2002 wrote:

Hi three tree, I was wondering if it's dried prunes or plums? You had mentioned both,Thanks

Dx 4/2013, IDC, Right, 5cm, Stage IIIA, 1/16 nodes, ER+/PR+, HER2- Surgery 6/13/2013 Lumpectomy: Right; Lymph node removal: Right, Sentinel; Mastectomy: Right Chemotherapy 6/20/2013 AC + T (Taxol) Radiation Therapy 12/27/2013 Breast, Lymph nodes Hormonal Therapy 3/31/2014 Arimidex (anastrozole)
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Sep 8, 2021 12:28AM - edited Sep 8, 2021 12:29AM by exbrnxgrl

Lexie,

They are the same! When a plum dries, it's called a prune though I know there has been some effort to replace the name prune with dried plum. Some think prune has a negative connotation. There is a particular variety, maybe more than one, specifically grown to be dried. Before our lovely valley started sprouting silicon chips, we were the Valley of the Hearts Delight. That delight? Our fruit orchards. The blossoms on Blossom Hill Rd. were fruit trees in bloom. That last orchard in LG, near Hwy 17 and Lark Ave. seems to have grown houses…

Bilateral mx 9/7/11 with one step ns reconstruction. As of 11/21/11, 2cm met to upper left femur Dx 7/8/2011, IDC, Left, 4cm, Grade 1, 1/15 nodes, mets, ER+/PR+, HER2- Surgery 9/7/2011 Lymph node removal: Left; Mastectomy: Left, Right; Reconstruction (left); Reconstruction (right) Dx 11/2011, IDC, Left, 4cm, Stage IV, Grade 1, 1/15 nodes, mets, ER+/PR+, HER2- Hormonal Therapy 11/21/2011 Arimidex (anastrozole) Radiation Therapy 11/21/2011 Bone Hormonal Therapy 6/19/2014 Femara (letrozole) Hormonal Therapy Aromasin (exemestane)
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Sep 8, 2021 05:19AM Jelson wrote:

Having just seen this article yesterday, I thought I would share it in this discussion. It is not specific to those with breast cancer who are taking hormonal drugs known to impact bone loss, but I found it interesting how strong the recommendations are for non-pharmaceutical treatment - first. https://journals.lww.com/menopausejournal/Abstract/2021/09000/Management_of_osteoporosis_in_postmenopausal.3.aspx

Dx 4/17/2009, DCIS, <1cm, Stage 0, Grade 3, 0/0 nodes, ER+/PR+
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Sep 8, 2021 09:36AM ThreeTree wrote:

Lexie - exbrnxgrl beat me to it! Yes, prunes and dried plums are the same thing! Ruthbru, the "dried plum" lady I mentioned before who posts on here, shared a little chuckle with me previously in a post or two about the fact that "prunes" has that negative image of just being something like "old people's laxative" when in reality they have much more to offer people of all ages, and that they are delicious too. She noted too, that the preferred term these days is "dried plums". What a difference semantics makes, huh? Thank you for explaining, exbrnxgrl!

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Oct 1, 2021 07:22PM lexie2002 wrote:

What brand should I buy? Does it matter? I have tons of bone pain. :(

Thanks,

Lexie

Dx 4/2013, IDC, Right, 5cm, Stage IIIA, 1/16 nodes, ER+/PR+, HER2- Surgery 6/13/2013 Lumpectomy: Right; Lymph node removal: Right, Sentinel; Mastectomy: Right Chemotherapy 6/20/2013 AC + T (Taxol) Radiation Therapy 12/27/2013 Breast, Lymph nodes Hormonal Therapy 3/31/2014 Arimidex (anastrozole)
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Oct 1, 2021 07:25PM exbrnxgrl wrote:

lexie,

Any brand of dried plum/prune will do the trick! I like Trader Joe’s prunes as they are always very moist.

Bilateral mx 9/7/11 with one step ns reconstruction. As of 11/21/11, 2cm met to upper left femur Dx 7/8/2011, IDC, Left, 4cm, Grade 1, 1/15 nodes, mets, ER+/PR+, HER2- Surgery 9/7/2011 Lymph node removal: Left; Mastectomy: Left, Right; Reconstruction (left); Reconstruction (right) Dx 11/2011, IDC, Left, 4cm, Stage IV, Grade 1, 1/15 nodes, mets, ER+/PR+, HER2- Hormonal Therapy 11/21/2011 Arimidex (anastrozole) Radiation Therapy 11/21/2011 Bone Hormonal Therapy 6/19/2014 Femara (letrozole) Hormonal Therapy Aromasin (exemestane)
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Oct 1, 2021 07:58PM ThreeTree wrote:

I get them in the bulk food section of my local organic co-op. I can get them at a local supermarket too in the bulk section too, but they are drier than the ones I get at the co-op. Think I'll look at Trader Joe's too after what exbrnxgrl said above. I just avoid those standard grocery store ones, like the ones in little individual wrappers, etc.

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Oct 2, 2021 08:59PM - edited Oct 3, 2021 12:25PM by PamEP

Love those prunes!

My last recent Dexa came back with lower osteopenia T-scores. Just in time for my MO consult regarding AI's. He favors Arimidex for my ER+ with Fosamax or Reclast to counter my progressive osteopenia. Geez, I would rather prunes and bone health supplements. The thought of cutting out estrogen terrifies me so I am considering trying Tamoxifen first rather than an AI, or maybe Tamoxifen then switching to an AI if I can beef up my T-scores. My MO is fine with that if I make that decision. Our choices are so poor, choose bad bones and heart disease or how about blood clots and uterine cancer...

A pretty good book on supplements: "Your Bones" by Lara Pizzomo.

Good article on Aromatase Inhibitor–Induced Musculoskeletal Symptoms: https://ascopubs.org/doi/full/10.1200/OP.20.00113

Article on Cardiovascular Disease Mortality Among Breast Cancer Survivors: https://academic.oup.com/jnci/article/113/2/137/5868410

Dx 7/26/2021, DCIS/IDC: Cribriform, Right, 1cm, Stage IA, Grade 1, 0/4 nodes, ER+/PR+, HER2- (IHC) Surgery 8/6/2021 Lumpectomy: Right; Lymph node removal: Sentinel Hormonal Therapy 10/15/2021 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Oct 3, 2021 04:44AM Rah2464 wrote:

Thanks for the article post PamEP it was very interesting. It is obvious that estrogen plays such a vital role in our overall health.

Dx 5/23/2018, IDC, Left, 1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2- (IHC) Surgery 6/26/2018 Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy 7/26/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Oct 3, 2021 11:21AM Spookiesmom wrote:

these aren’t bad. I get at Publix.
First time IDGgrade 3, stage 3. Second time, found lump myself. That made me stage 4. Dx IDC, Stage IIIA, Grade 3
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Oct 7, 2021 09:49PM lexie2002 wrote:

Can I ask what foods your referring to for bone health??

Thank You

Dx 4/2013, IDC, Right, 5cm, Stage IIIA, 1/16 nodes, ER+/PR+, HER2- Surgery 6/13/2013 Lumpectomy: Right; Lymph node removal: Right, Sentinel; Mastectomy: Right Chemotherapy 6/20/2013 AC + T (Taxol) Radiation Therapy 12/27/2013 Breast, Lymph nodes Hormonal Therapy 3/31/2014 Arimidex (anastrozole)

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