|January 5, 2023
I have a 74 yo patient that has history of left breast cancer in 1997 s/p unilateral left mastectomy and chemo and radiation and tamoxifen, she was recently diagnosed with ALH, ADH , and adjacent intraductal papilloma,
Expert Response: Guidelines in general do not recommend prescribing preventive medication after age 75 as the risks outweigh the benefits. I would get another dexa now. If the patient wants to take medication and is otherwise healthy, based on the Dexa – if osteoporosis- recommend Raloxifene x 5 years AND if osteopenia or within normal, I would recommend exemestane. She can take the AI for 5 years but get a BMD annually.