Osteoporosis DX at age 32--red flag for bone mets?

I've never heard of any correlation between bone density and bone mets. I'm glad your endocrinologist is looking at other issues. In my case, I had significant bone loss while on tamox, so that could account for your recent change. But it sounds like you had low bone density prior to starting tamox (or getting a BC Dx, I would assume). It's hard to know why. But we can't undo the past, so it's good you're getting the input of a endocrinologist.

Yes, steroid use has been linked to osteoporosis. The fact you took them as a kid may mean you didn't develop enough bone growing up. Have you discussed this with your endocrinologist? Seems like important info.

Are the DEXA scans accurate? That's a fair question. My endo said it's best to have repeat tests done on the exact same machine. But he also said they are a bit subjective and there can be some small margin of error. He said if you jump off the table and get back on again and re-do the test, the results could be slightly different. So it's possible they are off by a small amount. You probably know this, but these numbers and categories are somewhat arbitrary. It's kind of like body weight. A person doesn't suddenly go from being normal weight, to overweight to obese. It's a gradual thing and it's the overall trend that's important.

I don't know if the DEXA scan results have any correlation to bone mets. Your endo may have an opinion. Aside from this measurement, do you have any reason to believe you have bone mets? You said you were stage 1. That suggests that the lymph nodes were clear, so the risk of any mets is extremely small. (or as my BS said, there are no guarantees, but this is as close as we get). I sounds like  your MO isn't ordering a CT scan, so you can discuss that further.  There are trade-offs with any tests. Full body CT scans expose you to a fair amount of radiation, so they usually aren't done unless there's a concern.

In terms of managing your ongoing bone health, based on my personal experience (and some studies I've read), tamoxifen can lead to bone loss in pre-meno women.  Endos don't recommend SERMS for pre-meno women. So if you're continuing you have your periods, and are concerned about bone loss, you may want to see if there are other options. I believe some women take shots to shut down their ovaries. This may or may not be your choice, but just an FYI. At this point, none of us can change the past, but there may be options for what we can do going forward.

Adelaide77 , both my endocrinologist and oncologist said I should make the tamoxifen decision based on my cancer risk, not due to bone health. There are options (and meds) to mitigate the impact on the bones.  I talked to my MO this week and even though I've taken tamox for two years she still wants me to continue at least for another year, and restart after I go through menopause.

Some of your SEs seems severe, like suicidal thoughts. Those shouldn't be treated lightly. I haven't heard of those as SEs from tamox. Have you talked to your doctors about the range of SEs and concerns?

I know I was on high alert when I started tamox. In my case, I waited six weeks after finishing rads before starting the drug. (I wanted time to do research plus I had a long trip planned). As luck would have it, during those six weeks, my knee started acting up again. If I had been on tamox I would have assumed there was a connection. So that was a good reminder for me, that just because symptoms appear (or come back) doesn't mean they are necessarily related to tamox. It's good to keep things in the perspective and look at the long road. 

Adelaide, I feel for you. I'm so sorry you are suffering with this kind of pain at such a young age. I don't know if this helps but taking vitamin K with vitamin D is suppose to help the assorption of D. I heard, debate over this, that calcium is supposely not good to take. Eating well, green foods and protein foods (raw milk) especially is good for bone health. Weight bearing exercise is also suppose to increase bone mass. Sugar bad and not so good for healing.

I'm a lot older and declined tamoxifen due to side effects. Sometimes for early stage cancer, and you had a mx the risk is miminal for recurrence. I decided against it because I too have otheoporisis in my lower back. I can't afford bone loss, and I'm allergic to Folsomex.

With all that said, because I have lower back pain now for 2 months my oncologist order a bone scan that I'm having tomorrow morning. She doesn't want to take chances. I sized it up to be nothing more than otheoporisis or arthirtis pain. Hopefully it's nothing more. To insert, I did read somewhere that there can be a connection between orthorporsis and bone cancer. Not sure, not enough info on it to know one way or the other. I' know I'm high risk so I'm being pro-activie.

Hope you get the help you need. Pain is horrible.  (((hugs)))