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A wealth of literature has described the negative effects of breast cancer treatments on bone health [27]: chemotherapy, radiation, and aromatase inhibitors both prevent bone formation and weaken bones to a greater extent than anti-estrogens or tamoxifen alone [28,29]. These and other factors, such as young age of the cancer survivor, can all contribute to bone loss. When it comes to cancer treatments, timing of chemotherapy and timing of menopause are also important variables. For example, chemotherapy could be delivered in stages, giving bone time to mature before it is treated, and/or leukocytic estrogen (LE) could be administered concurrently with chemotherapy to prevent chemotherapy-induced bone loss [30]. Treatment choices may also differ based on the ER status of the cancer as well as the patient’s age. Most young breast cancer survivors are treated with adjuvant chemotherapy with or without endocrine therapy [31,32], but it is unclear how their bone health compares with survivors who lack the same treatment options. This would be especially the case in those who are fertility-sparing and choose hormone therapy over chemotherapy. Furthermore, treatment regimens are often selected based on tumor subtype, so differences may also exist based on different subtypes. For example, there may be a difference in bone health in women with a luminal tumor compared with those with a triple-negative or HER2-positive tumor. In the case of breast cancer survivors who undergo chemotherapy, much of the bone loss that occurs is due to menopause-related bone loss [29]. A small proportion of bone loss is due to a cytotoxic effect of chemotherapy on the bone marrow [33]. Exercise has also been shown to be an effective means to prevent some of the bone loss induced by menopause and chemotherapy and can improve bone density in cancer survivors [34, 27]; however, this benefit is still lower than in cancer-free women [35]. 7211a4ac4a