My tamoxifen appointment with him is Thursday (already had my mammo and bloodwork.)
Then I read on Twitter:
There's a pile of pages on bone loss in my medical file - full of "In the absence of estrogen" it seems RANK/RANKL destroy not only bones that need replacement, but eagerly move onto bones we're still using. Siccing Prolia on the RANK/RANKL was the answer...
The study covered here says RANK/RANKL also work in "formation of a lactating mammary gland in pregnancy'" And the authors say:
"Based on their normal physiology, RANKL/RANK control the onset of hormone-induced breast cancer through the expansion of mammary progenitor cells."
For some reason, the abstract seemed to gloss over that or over-simplify, and I don't have the complete test.
The abstract concludes: "we propose that anti-RANKL therapy could be a feasible preventive strategy for women carrying BRCA1 mutations, and by extension to other women with high risk of breast cancer.
I wonder what my oncologist will say about this...