Postmenopausal, Osteopenic, Refused AI and Taking SERM Instead?

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corky60
corky60 Member Posts: 726
edited June 2014 in Bone Health and Bone Loss

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?

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  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited May 2013

    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.

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  • micronancy
    micronancy Member Posts: 51
    edited June 2013

    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.

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited June 2013

    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.

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  • mom2twins34
    mom2twins34 Member Posts: 185
    edited June 2013

    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... :-)

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  • Jeannie57
    Jeannie57 Member Posts: 2,144
    edited June 2013

    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.

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  • ICanDoThis
    ICanDoThis Member Posts: 1,473
    edited June 2013

    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

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  • Golden01
    Golden01 Member Posts: 916
    edited June 2013

    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. 

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  • Member_of_the_Club
    Member_of_the_Club Member Posts: 3,646
    edited July 2013

    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.

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