It is all hitting me now . . .

Beeba, Im so sorry your going through this. Id recommend asking your gp for some mild sleeping pills, getting a few good nights sleep and then relooking at all the issues. Theres no immediate urgency in making this decision and a few days or weeks of getting some sleep and recovering your normal happier self wont affect your prognosis.

You dont say how old you are, but Im assuming you are in your 50's to 60's based on being post menopausal and the doctors mother being 12 years older. At 42 on my diagnosis which was initially DCIS grade 3 I was happy to throw everything including the kitchen sink at my cancer. I was told masectomy and then arimidex at that stage and while I ended up with some IDC and chemo was introduced to the equation I had already happily decided to do everything the BS and oncologist recommended. I wasnt given percentages etc, I was given the recomendations they both felt would best ensure that I wouldnt have a recurrance and with them knowing I was prepared to do anything possible to get the cancer out and to keep it out to the best of all our abilities.

My mother at 72 has told me that if she is diagnosed with any form of cancer she will be declining chemo and for her children not to try and press her otherwise. My mother prefers quality of life over quantity while at my age I prefer to have long term gains plus peace of mind over short term quality of life. 

The decision has to be whatever ends up giving you the greatest peace of mind. I really do think some assistance in getting a few goods night sleep will help clear your mind and then you can proceed to make a calm decision based on all facts to hand. I will say that while the side effects of the hormonals can really suck sometimes, at nearly 3 years in I manage my life very well and the side effectshavent been sufficient to stop me working fulltime on my feet since about the 1st month of taking them.

Wishing you the very best in whatever you do decide to do and sending comforting peaceful thoughts your way

Beeba,  I am an analytical type persona and I would think about it this way.  If your risk of getting cancer in your other breast is 1-2%, then it is 98%-99% chance you won't get it.   And if Tamox reduces this by 45% that is reducing the chances to roughly .5%-1%.  So if you take tamox, 99%-99.5% chance it is not stopping a cancer, - i.e. doing nothing but giving you side effects and risks - (either being in the % that wasnt going to get it anyway or the small % that will get it anyway with tamox ) and only .5%-1% that it actually prevents something.

One option might be to try it and see how the side effect are.  You can always stop taking it after a day, weeek, month or year if you notice quality of life problems.

Personally, I chose not to take tamox, even though I am pre-menopause.  I am making lifestyle and diet changes (no processed foods, more exercise, no plastic container, reduced dairy- only organic, etc) and it is unknown if this will do anything for the estrogen in my system, but this the choice that is right for me....i have always preferred to avoid pills and medicines whenever possible.  I will be VERY dilligent about my follow-up and regular self-breast exams, hopefully to find something early if i do have a problem.   I have asked myself several times the same thing your sister asked...how would you feel if you got BC again....and obviously i would be devistated,  and wonder what would have happened had I taken tamox.  If a recurrance was invasive i would look back and admit that I made a mistake.  And probably would take tamox despite side effects if i got it again.

If you are the type to stay awake worrying about it if you decilne that too is a side effect of the decision not to take tamox, a side effect that could affect QOL too.

Good luck with your decision. 

Beeba- I agree that 1-2% chance of a new breast cancer in your other breast seems too low - as if since you got it in one breast, your other is "home free"? In our tamoxifen discussion, my oncologist told me,  your unaffected breast was exposed to everything your affected breast was exposed to. Not to freak you out, but alot of the literature addresses reoccurance ie, in the affected breast-Which you still have, since like me, you had a lumpectomy, not a mastectomy. In any event, I find the whole risk discussion very difficult to wrap my head around. I am pasting in two citations for you - to read when and if you feel like it - after you have gotten some rest.  The first is on risk and dcis and tamoxifen.  The second article talks about the longer term impact of tamoxifen.  http://dcis.info/understanding_risk.html     and http://www.breastcancer.org/treatment/hormonal/new_research/20110728.jsp

and you don't have to decide about tamoxifen right away and if you start, you can quit if you don't like the side-effects/risks.

Hugs to you,

Julie E