Medical Oncologist
Medicines
Tests and monitoring while you are on anastrozole
Anastrozole does not need frequent blood tests, but lowering oestrogen for years affects bones and cholesterol. This page explains the checks commonly arranged, including DEXA scans, vitamin D, cholesterol and hormone tests, how often they happen in general terms, what results mean and which symptoms to report without waiting.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
On this page
- Which tests and checks will you have while taking anastrozole?
- Four kinds of monitoring on anastrozole
- When checks are commonly done, in general terms
- The vocabulary, in plain language
- What tests can and cannot show
- What happens after your bone scan
- Symptoms to report without waiting for a test
- What people assume about tests on anastrozole
- Common questions about monitoring on anastrozole
The short answer
Which tests and checks will you have while taking anastrozole?
Anastrozole does not need frequent blood tests, but because it lowers oestrogen for years, your team will keep an eye on a few areas. The most important is bone health. A bone density scan, called a DEXA scan, is commonly done around the start of treatment and repeated every one to two years if your bones are thin or you have other risk factors. A vitamin D blood test is often arranged too, since low levels are very common in India and weaken bones further, and calcium may be checked. Your doctor may also check cholesterol and blood fats from time to time, because anastrozole can raise them modestly, along with blood pressure and blood sugar as part of general heart health. If you are younger, had chemotherapy that stopped your periods, or there is any doubt about menopause, hormone blood tests for oestradiol and FSH may be done before starting and during treatment, to make sure the ovaries are not active. Liver blood tests are sometimes checked at the start or if symptoms suggest a problem. Alongside tests, regular follow-up appointments matter: your doctor will ask about side effects, examine your breasts and chest area, and arrange yearly mammograms of any remaining breast tissue. For early breast cancer, routine blood tumour markers and whole-body scans are not recommended when you feel well, because they do not improve outcomes. The exact schedule varies with your age, health and results, and between hospitals.
Bone scans are central
DEXA scans and vitamin D tests help prevent fractures during treatment.
Heart checks matter too
Cholesterol, blood pressure and blood sugar are reviewed periodically.
Routine cancer scans are not needed
Follow-up visits and mammograms are the main checks for early breast cancer.
This page gives general information only. Your oncology team will decide the tests and timing that suit you.The main checks
Four kinds of monitoring on anastrozole
Each looks after a different part of your health during treatment.
Bone density
A DEXA scan measures bone strength at the hip and spine and guides whether bone treatment is needed.
Vitamin D and calcium
Blood tests show whether supplements are needed to support bone health.
Supplements are taken at the dose your doctor advises.Heart risk factors
Cholesterol, blood pressure, blood sugar and weight are checked from time to time.
Breast follow-up
Clinic reviews and yearly mammograms look for any sign of recurrence or new cancer.
Bring to each visit
- Recent test reports
- Your full medicine list
- Notes on side effects and new symptoms
Typical timing
When checks are commonly done, in general terms
Check
Usual timing
DEXA bone scan
Near the start, then every one to two years if needed
Vitamin D
Near the start, and after a course of supplements
Cholesterol
Near the start and periodically during treatment
Hormone levels
Only when menopause status is uncertain
Mammogram and clinic visit
Regular visits, and a mammogram usually each year
Words you will hear
The vocabulary, in plain language
- DEXA scan
- A quick, low-dose X-ray scan that measures bone density.
- T-score
- A number on a bone scan comparing your bone density with that of a healthy young adult.
- Twenty-five hydroxy vitamin D
- The blood test used to measure your vitamin D level.
- Lipid profile
- A blood test for cholesterol and other fats.
- FSH and oestradiol
- Hormone blood tests that help confirm whether the ovaries have stopped working.
- Tumour markers
- Blood tests such as CA fifteen-three, not routinely used for early breast cancer follow-up.
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Call the helpline or leave your details, and someone will help you arrange a consultation at the CION centre nearest you. One helpline serves every CION centre.
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Being straight with you
What tests can and cannot show
It is natural to want tests that prove everything is fine. Monitoring on anastrozole has a narrower purpose.
No test shows the tablet is working
There is no blood test for anastrozole's effect on cancer. Its benefit comes from taking it steadily.
Extra scans can cause harm
Routine whole-body scans in women without symptoms can find harmless changes, leading to worry and further tests, without improving survival.
Access varies
Bone scans are not available everywhere. Your doctor may use risk tools and clinical judgement where scans are hard to arrange.
What this page cannot tell you
It cannot interpret your reports. Your oncologist can explain what your results mean.
Understanding results
What happens after your bone scan
Your bone scan result, together with age and other risks, shapes the next steps.
Normal bone density
Lifestyle measures and adequate vitamin D are usually enough, with a repeat scan at intervals if advised.
Mildly thin bones
Supplements, exercise and a repeat scan in one to two years are common.
Osteoporosis or high fracture risk
A bone-strengthening medicine such as zoledronic acid, alendronate or denosumab may be started, and anastrozole is usually continued.
Low vitamin D
A course of higher-dose vitamin D followed by a maintenance dose is often advised.
Between visits
Symptoms to report without waiting for a test
You notice changes in your body before any test does. Contact your team if you have any of the following.
Bone and joint changes
New bone pain that persists or worsens, pain at night, or a fracture after a minor fall.
Breast and chest changes
A new lump, thickening, skin change or swelling in the breast, chest wall, armpit or neck.
General changes
Lasting breathlessness or cough, unexplained weight loss, tummy swelling, yellowing of the skin, severe headaches or vaginal bleeding.
Commonly believed
What people assume about tests on anastrozole
Regular PET scans catch recurrence earlier and save lives.
For early breast cancer without symptoms, routine scans have not been shown to help.
A normal blood count means the cancer is gone.
Blood counts do not show whether breast cancer is present.
Bone scans and DEXA scans are the same.
A DEXA scan measures density; a bone scan looks for cancer in bones.
Vitamin D is only needed if you feel unwell.
Low vitamin D often causes no symptoms but still weakens bones.
Questions we are asked
Common questions about monitoring on anastrozole
Is a DEXA scan safe?
Yes. A DEXA scan uses a very small amount of radiation, far less than a standard chest X-ray. You lie on a table for a few minutes while a scanner arm passes over your hip and spine. It is painless and needs no injections.
How often should cholesterol be checked?
This varies. Many doctors check it near the start and then periodically, more often if you have diabetes, high blood pressure or heart disease. Your family doctor can usually arrange it alongside other routine health checks.
Why is my doctor checking whether I am in menopause?
Anastrozole works properly only if the ovaries are not making oestrogen. After chemotherapy, periods can stop for a while and then return. Hormone tests help confirm your status, and your doctor may suggest ovarian suppression or tamoxifen if there is doubt.
Should I ask for tumour marker tests?
For early breast cancer, guidelines do not recommend routine tumour markers, as they can rise for harmless reasons and miss real changes. In advanced cancer they are sometimes used alongside scans. Your oncologist can explain why they are or are not used for you.
What does a T-score on my report mean?
It compares your bone density with that of a healthy young adult. Scores close to normal are reassuring, while lower scores indicate thinning or osteoporosis. Doctors combine the T-score with your age and other risks before deciding on treatment.
Can tests be done near my home?
Often, yes. Vitamin D, cholesterol and general blood tests can be done at local laboratories, and many cities have DEXA scanners. Share every report with your oncology team and keep copies together in one folder.
Do I need eye or heart scans on anastrozole?
Routine eye or heart scans are not usually needed for anastrozole itself. They may be advised for other reasons, such as diabetes, symptoms or other cancer treatments you have had. Mention any new symptoms to your doctor.
Will monitoring continue after I stop anastrozole?
Breast follow-up and mammograms continue after hormone therapy ends. If your bones were thin, bone checks and treatment may continue for a while too. Your team will explain your long-term follow-up plan.
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Call the helpline or leave your details, and someone will help you arrange a consultation at the CION centre nearest you. One helpline serves every CION centre.
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Sources
- National Cancer Institute — Anastrozole
- American Society of Clinical Oncology — Follow-up care for breast cancer
- Breast Cancer Now — Anastrozole (Arimidex)
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.