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Anastrozole is a selective competitive aromatase inhibitor (AI) widely used as adjuvant treatment for early stage breast cancer. Highly efficient estrogen depletion by AI benefits breast cancer (BC) patients by extending recurrence-free survival. However, AIs put patients at high risk of osteoporosis due to the central role of estrogen in maintaining normal bone metabolism. Although awareness of osteoporosis by health care professionals has increased in recent years, it remains underdiagnosed and undertreated. Findings of this study should raise awarness of the importance of BMD screening among BC patients treated with anastrazole and to tailor treatment and prevention strategies for Al users as a high - risk population for bone morbidity. The intensity of adverse effects plays an essential part in maintaining patient complience to anastrazole therapy. Functional genetic polymorphisms of enzymes involved in anastrazole metabolism could be correlated to altered aromatase activity, disease prognosis and severity of aromatase inhibitor adverse effects, however large genotyping studies are obligatory.