A 63-year-old postmenopausal woman treated with oral alendronate for osteoporosis

  • History of breast cancer treated with lumpectomy, radiation therapy, and 5 years of tamoxifen

  • Outside DXA scans showed a progressive decline in her lumbar spine T-score from −3.1 to −3.3

  • Femoral neck bone density was stable

  • Past medical history was otherwise unremarkable

  • No history of lactose intolerance, celiac disease, or chronic glucocorticoid use

  • She did not take calcium supplements, but took over-the-counter vitamin D

  • No history of antifracture therapy.

The patient was prescribed oral alendronate 70 mg once weekly.
Bone mineral density and bone turnover markers:
Before treatment3 months1 year
 Lumbar spineNA−2.6
 Left femoral neckNA−1.5
 Right femoral neckNA−1.5
Bone turnover marker:
C-terminal telopeptide of type I collagen
653 pg/mL361 pg/mL
(45% reduction from baseline)
188 pg/mL
(72% reduction from baseline)
  • NA = Not available: baseline dual-energy x-ray absorptiometry (DXA) was done at an outside facility and thus was not appropriate for comparison.