Treatment Options Hormone Therapy

I’ve been diagnosed with breast cancer (one breast with one lymph node involvement, possibly two). Breast and node are HER2 positive. I have rejected preferred treatment of chemotherapy and surgery, and have accepted alternative of treatment (Letrozole plus Adcal D3). I’m content with this treatment plan however, I have more recent diagnosis of underlying very high blood pressure plus high cholesterol and a recent DEXA scan shows osteopenia of hip and osteoporosis of lumber spine. Also, for the past 3 years my RBC count has been abnormally high.

I am reluctant to take multiple medications which mitigate against each-and-all known side-effects of an aromatase inhibitor.

My priority is to maximise my quality of life and currently I feel physically well. I am however particularly concerned about the possibility of being hospitalised with a bone fracture and/or thrombosis/stroke. I have not had a nuclear scan to identify if the cancer has spread to the bone.

On your website I’ve read:

‘Bisphosphonates help strengthen your bones and reduce your risk of fractures.’


‘Bisphosphonates may be used as a treatment to reduce the risk of primary breast cancer spreading. They are also sometimes given as a treatment for secondary breast cancer in the bone.’

My question is:

Given that my current concern is exacerbation (through use of Letrozole) of my underlying conditions (high blood pressure, etc.) could I consider discussion with Consultant/GP the use of Bisphosphonates rather than an aromatase inhibitor. This in the knowledge that it would have little direct effect on the localised breast cancer but might have advantageous effect on stabilising my osteoporosis.

I have bone mets, and I have denosumab injections every 4 weeks, it strengthens my bones, demonstrated on DEXA scan. I also had targeted therapy (Ribociclib) and hormone blocker (fulvestrant) for 4 years, until it stopped working, now on capecitabine.
All the best whatever you decide.