Aromatase inhibitors such as anastrozole (Arimidex), letrozole (Femara), exemestane (Aromasin) can also cause bone loss in postmenopausal women because they inhibit  an enzyme known as aromatase from turning androgen into estrogen in other parts of the body besides the ovaries. In general, they are believed to result in more bone loss than Tamoxifen, which is often prescribed for a long term to help breast cancer from recurring. As a result, some researchers recommend that women who switch from Tamoxifen to an aromatase inhibitor – such as may be the case after a recurrence of the cancer or severe side effects from the drug – undergo a baseline bone density scan.

In addition to chemotherapy drugs, glucocorticoids, which are most commonly prescribed if the breast cancer metastasizes in another part of the body to reduce inflammation – are also known to cause bone loss. Furthermore, there is some evidence – not yet fully understood – that the breast cancer itself may contribute to osteoporosis. According to the National Institutes of Health, the breast cancer may stimulate the production of osteoclasts, cells that break down bone in the body.

A woman who has suffered breast cancer may be predisposed to osteoporosis for a number of reasons, but the bone loss is not inevitable. The American Society of Clinical Oncology (ASCO) advises women considered at high risk, such as postmenopausal women taking aromatase inhibitors or women with therapy-associated menopause undergo annual bone density screenings (DEXA), rather than waiting until age 65 for scans every other year as recommended for most women.

In the aftermath of breast cancer, you should do your best to consume enough calcium and Vitamin D, continue to monitor your bone density and discuss other potential preventive measures, including prescription medication, with your physician. After having made it through breast cancer, you owe it to yourself to take care of your bones and safeguard your health for the years to come.