Bisphosphonate and Anastrozole Trial - Bone Maintenance Algorithm Assessment

Inclusion Criteria: * Postmenopausal * Adequately diagnosed and treated Stage I-IIIa early breast cancer * Oestrogen receptor and/or progesterone receptor positive breast cancer * Eastern Cooperative Oncology Group (ECOG) performance status less than or equal to 2 * Hormone replacement therapy (HRT) must be discontinued at least 2 weeks prior to registration * Any prior tamoxifen taken for a total of 8 weeks or less * Any prior anastrozole taken for a total of 4 weeks or less * Anastrozole is clinically indicated to be the best adjuvant strategy * Signed written informed consent Exclusion Criteria: * Clinical or radiological evidence of distant spread of disease * Prior treatment with bisphosphonates within the past 12 months * Prior treatment with continuous systemic corticosteroids within the past 12 months * Prior use of parathyroid hormone for more than 1 week * Prior use of systemic sodium fluoride for \> 3 months during the past 2 years * Currently treated with any drugs known to affect the skeleton * Abnormal renal function (serum creatinine greater than or equal to 265.2 mmol/L) * History of diseases with influence on bone metabolism. Patients with lactose intolerance are also excluded * Delayed oesophageal emptying such as stricture or achalasia * Hypersensitivity to alendronate or anastrozole * Previous or concomitant malignancy within the past 5 years EXCEPT adequately treated basal or squamous cell carcinoma of the skin or in situ carcinoma of the cervix * AST/SGOT and/or ALT/SGPT \> 3 x ULN in combination with other laboratory and clinical abnormalities indicating liver insufficiency * Fracture due to minimal trauma, demonstrated radiologically