Do you avoid teriparatide in previously irradiated breast cancer patients with osteoporosis given the black box warning for potential risk of osteosarcoma?   

Generally, teriparatide is avoided in breast cancer, previously irradiated or not, because of black box warning. Treatments for osteoporosis (based exceeding fracture thresholds with fracture risk prediction tool e.g. FRAX or Garvin) include oral bisphosphonates, IV zoledronic acid either once or tw...