Is there a degree of osteoporosis (based on T-score) that would prohibit you from the utilization of an AI in a strong HR+ early stage breast cancer?
What factors if any would influence your decision and what would your approach be?
Answer from: Medical Oncologist at Community Practice
Tamoxifen is often underutilized in many patients who otherwise have a narrow benefit/risk ratio from an AI. It is more preserving and more tolerated, and should be used more readily in the majority of patients with lower risk disease.
Using a sequence of tamoxifen and an AI is also very reasonable...
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Answer from: Medical Oncologist at Academic Institution
This is a nuanced question that requires a nuanced answer. There isn’t necessarily a clear T-score or FRAX that would prohibit me from using an AI, but I would weigh the following factors:
What is the patient's risk tolerance for fractures vs cancer recurrence?
Are they followed by a bone ...