Medical Oncologist
Medicines
Tests and monitoring while you are on letrozole
Letrozole is simple to take, but years of low oestrogen can affect your bones and cholesterol. This page explains the checks commonly arranged on letrozole, including bone density scans, vitamin D and hormone tests, how often they happen in general terms, and which symptoms to report without waiting for your next appointment.
NG
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 will you need while you take letrozole?
- Four areas your team keeps an eye on
- When tests are commonly done, in general terms
- The vocabulary, in plain language
- What monitoring can and cannot do
- What happens if your bones are thinning
- Symptoms to report without waiting for a test
- What people assume about tests on letrozole
- Common questions about monitoring on letrozole
The short answer
Which tests will you need while you take letrozole?
Letrozole is a hormone tablet that lowers the amount of oestrogen in the body, and it is usually taken for several years after treatment for hormone-receptor-positive breast cancer, or for longer when the cancer has spread. The tablet itself is simple to take, but because it changes hormone levels over a long time, your team will want to keep an eye on a few things. The main areas are bone strength, cholesterol and blood fats, vitamin D and calcium, and, for some women, blood tests that confirm the ovaries are no longer making oestrogen. Letrozole works well only after menopause, so if you became menopausal recently, had chemotherapy that stopped your periods, or are younger, your doctor may check hormone levels before and during treatment. A bone density scan is often done near the start, because lower oestrogen speeds up bone thinning, and it may be repeated every one to two years depending on the result. Blood tests for cholesterol and sometimes liver function may be checked from time to time. Just as important are regular follow-up visits, where your doctor asks about side effects, examines you and arranges breast imaging. Letrozole does not usually need frequent blood counts, and routine scans of the whole body are not needed when you feel well. The exact schedule varies between hospitals and depends on your age, your other health conditions and your results.
Bones come first
A bone density scan, along with vitamin D and calcium checks, helps protect you from fractures during years of low oestrogen.
Hormone checks for some women
If there is any doubt that you are past menopause, blood tests help confirm that letrozole is the right tablet for you.
Follow-up matters as much as tests
Telling your team about side effects and new symptoms is a key part of monitoring.
This page gives general information only. Your oncology team will set the tests and timing that suit you.The main checks
Four areas your team keeps an eye on
Most monitoring on letrozole is about the long-term effects of low oestrogen.
Bone density scan
A DEXA scan measures bone strength at the hip and spine. It is quick and painless, and uses a very small amount of radiation.
Vitamin D and calcium
A blood test checks vitamin D. Low levels are common in India, and topping them up supports your bones.
Supplements are often advised if levels are low.Cholesterol
Letrozole can raise cholesterol in some women. A lipid profile helps your doctor decide whether diet changes or medicines are needed.
Menopause status
Blood levels of oestradiol and FSH help show whether the ovaries have stopped working, which matters most for women under about sixty.
Checked more carefully if
- Your periods stopped during chemotherapy
- You are in your forties or early fifties
- You have had a hysterectomy but kept your ovaries
Typical timing
When tests are commonly done, in general terms
Test or visit
Usual timing
Bone density scan
Near the start, then every one to two years if needed
Vitamin D level
Near the start, and rechecked if supplements are given
Cholesterol and blood fats
Near the start and then periodically
Hormone levels
Before starting and at intervals, only when menopause is uncertain
Clinic review and mammogram
Regular visits, with yearly breast imaging for most women
Words you will hear
The vocabulary, in plain language
- DEXA scan
- A low-dose X-ray scan that measures how dense and strong your bones are.
- T-score
- The number on a bone scan report comparing your bones with those of a healthy young adult.
- Osteopenia
- Bones that are thinner than normal but not yet thin enough to be called osteoporosis.
- Osteoporosis
- Thin, fragile bones that break more easily.
- Lipid profile
- A blood test measuring cholesterol and other fats.
- Oestradiol and FSH
- Hormone blood tests that help show whether the ovaries are still active.
Talk to our team
Have a question about your situation?
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.
Call 1800 202 8726
Helpline open 24/7
Being straight with you
What monitoring can and cannot do
Tests on letrozole are mostly about keeping you well during treatment. They are not a way of checking, month by month, whether the cancer is coming back.
No blood test shows the tablet is working
There is no routine test that proves letrozole is doing its job. Its benefit comes from years of steady use, which is why taking it every day matters.
Tumour markers are not routine
For early breast cancer, blood tumour markers and whole-body scans are not usually advised when you feel well. They can give false alarms without improving outcomes.
Schedules vary
Hospitals follow slightly different guidelines, and access to bone scans differs between cities. A different timetable from a friend's does not mean one of you is wrong.
What this page cannot tell you
It cannot interpret your own results. Your oncologist can explain what they mean for you.
After the scan
What happens if your bones are thinning
Finding thinner bones is common on letrozole and does not usually mean stopping the tablet. Instead, your team adds steps to protect your skeleton.
Lifestyle first
Weight-bearing exercise such as brisk walking, strength work, calcium-rich foods like milk, curd, ragi and sesame, and stopping smoking all help bones.
Supplements
Vitamin D and sometimes calcium tablets are advised, at the dose your doctor recommends.
Bone-strengthening medicines
If bone loss is more marked, or your fracture risk is high, your doctor may suggest a bisphosphonate such as zoledronic acid, or denosumab. A dental check is often advised before starting these.
Between visits
Symptoms to report without waiting for a test
You are part of the monitoring. Keep a simple note of how you feel and bring it to each appointment, but contact your team sooner for the following.
New or lasting pain
Bone pain that is new, gets steadily worse or wakes you at night should be checked, as should a fall that causes pain.
Breast or chest changes
A new lump, skin change or swelling in the breast, chest wall or armpit needs prompt review.
Other warning signs
Tell your team about vaginal bleeding after menopause, lasting breathlessness, a cough that does not settle, unexplained weight loss or yellowing of the skin.
Commonly believed
What people assume about tests on letrozole
More scans mean better care.
Routine whole-body scans in women who feel well do not improve outcomes after early breast cancer.
Normal blood counts prove letrozole is working.
Blood counts say little about letrozole. Its benefit comes from regular use.
Thin bones mean you must stop letrozole.
Most women continue, with supplements, exercise or bone medicines added.
If periods have stopped, menopause is certain.
After chemotherapy, the ovaries can restart, so blood tests may be needed.
Questions we are asked
Common questions about monitoring on letrozole
Do I need a bone scan before starting letrozole?
Many guidelines recommend a bone density scan near the start of treatment, so there is a baseline to compare with later. If a scan is hard to arrange, your doctor may use your age and other risk factors to judge your bone health and plan the scan soon after.
How often will my cholesterol be checked?
This varies. Many doctors check it near the start and then every so often, especially if you already have high cholesterol, diabetes or heart disease. Your family doctor can often do this test alongside your usual health checks.
Why is my doctor checking hormone levels?
Letrozole does not work properly if the ovaries are still active. If your periods stopped recently or during chemotherapy, hormone blood tests help confirm menopause. If there is doubt, your doctor may suggest tamoxifen instead or add ovarian suppression.
Will I need regular tumour marker tests?
For early breast cancer, usually not. Tumour markers can rise for harmless reasons and miss real changes. They are used more often when cancer has spread, to help track how treatment is going alongside scans and symptoms.
Do I need liver tests on letrozole?
Letrozole rarely affects the liver in a serious way, so frequent liver tests are not usually needed. Your doctor may check liver function at the start or if you have liver disease, take other medicines that affect the liver, or develop symptoms.
Can my family doctor do some of these tests?
Often, yes. Vitamin D, cholesterol and general blood tests can be done locally. Share the results with your oncology team so everything is in one place, and keep copies of each report in a single folder.
What should I bring to follow-up visits?
Bring your latest reports, a list of all medicines and supplements, and notes on side effects such as joint pain, hot flushes or mood changes. Write down any questions beforehand so nothing is forgotten on the day.
Does monitoring stop when I finish letrozole?
Breast follow-up continues after hormone therapy ends. Bone health may still be checked if your bones were thin, although bone density often improves partly after the tablet stops. Your team will tell you what long-term follow-up looks like.
Meet the Specialists
17+ senior cancer specialists. One panel for your case.
Trained at AIIMS, Tata Memorial, and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them — together.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
Want a specific doctor for your case? Mention them when booking.
Book Free ConsultationBook an appointment with our specialist
Share your name and number — we'll call you back within 30 minutes to schedule your consultation.
Where to find us
Our centres in and around Hyderabad
Addressed by landmark, because that is how this city navigates. Each centre also names the areas it serves, so you can place it without a map. Consultation and day-care Chemotherapy run at every one of them.
Warangal
Vizag
Talk to our team
Speak to a breast cancer specialist
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.
Call 1800 202 8726
Helpline open 24/7
Sources
- National Cancer Institute — Letrozole
- Macmillan Cancer Support — Letrozole
- American Society of Clinical Oncology — Follow-up care for breast cancer
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.