Figure 3

Recommended management strategy for patients with breast cancer receiving aromatase inhibitor therapy. Recommendations based on results from trials in breast cancer patients and healthy populations. The largest body of evidence for treatment of aromatase inhibitor (AI)-associated bone loss is for zoledronic acid (4 mg every 6 months). ^aIf patients experience an annual decrease in bone mineral density (BMD) ≥5% (using the same dual-energy X-ray absorptiometry machine), secondary causes of bone loss such as vitamin D deficiency should be evaluated and bisphosphonate therapy considered. Use the lowest T score from three sites. BMI, body mass index. Reprinted from [1] with permission from the European Society for Medical Oncology.