ESR1 and breast cancer: Selective estrogen receptor modulators (e.g., raloxifene) are agents that interact with intracellular estrogen receptors in target organs as estrogen agonists and antagonists.28When compared with menopausal hormone therapy, it has less impact on BMD.23They are indicated for postmenopausal women with osteoporosis in whom bisphosphonates or denosumab are not appropriate and who have low risk of thrombosis and high risk of breast cancer.22, 23