| Inclusion criteria |
---|---|
1. | Pathologically confirmed stage I to III breast cancer with no recurrence and metastasis. |
2. | Completed chemotherapy and/or radiotherapy. |
3. | Currently using a third-generation aromatase inhibitor (anastrozole, letrozole, or exemestane) and self-reported ongoing musculoskeletal symptoms (arthralgia and/or stiffness and/or swelling in one or more joints, bone pain, myalgia, carpal tunnel syndrome, trigger finger), which started or worsened after initiation of aromatase inhibitor therapy and has continued for more than 1 month, and who had a baseline worst pain score over the past week on the Brief Pain Inventory-Short Form ≥3 points on a scale of 0 to 10. |
4. | Eastern Cooperative Oncology Group performance status 0-2. |
5. | Provided written informed consent before enrollment. |
 | Exclusion criteria |
1. | Patients with endocrine and any other diseases influencing bone metabolism (for example, hyperthyroidism, hypothyroidism, diabetes, Cushing’s syndrome, chronic liver disease, nephropathy, myeloma, bone tumor, or bone metastasis). |
2. | Used of agents influencing bone metabolism (for example, glucocorticoid, thyroid hormone, heparin, anticonvulsants, diuretics, or bisphosphonates), except calcium agents, within the past 3 months. |
3. | Contraindications to calcium agents and vitamin D. |
4. | Diagnosed with primary osteoarticular diseases. |
5. | Presence of other primary tumors and severe heart, liver, kidney, and hematopoietic system diseases. |
6. | Presence of pregnancy, mental illness, or cognitive handicap. |