Denosumab and Slow-Jogging Aerobic Exercise in Aromatase Inhibitor-Associated Musculoskeletal Syndrome: A Case Series

As breast cancer incidence rises, aromatase inhibitor-associated musculoskeletal syndrome (AIMSS) has become increasingly prevalent, yet treatment remains diverse and lack clearly defined therapeutic targets. We report 3 postmenopausal breast cancer patients (mean age: 64.7 y) who developed AIMSS after more than 6 months of AIs therapy. After receiving denosumab and participating in slow-jogging aerobic exercise aimed at improving bone mineral density and reducing the android-to-gynoid fat ratio, all 3 patients demonstrated marked improvements in pain scores (Visual Analog Scale, VAS), grip strength, and joint imaging after one year of follow-up. Beyond traditional anti-inflammatory medications and symptom-focused management, we propose viewing AIMSS as a metabolic condition induced by hormone suppression that leads to arthritis. The combination of denosumab and slow-jogging aerobic exercise may help alleviate symptoms and improve adherence to AIs therapy in patients with AIMSS.