41 BMx for Dcis/ER/PR+.. No tamoxifen

I also want to add that I have friends that have been diagnosed with DCIS and I've seen the conflict and confusion they've gone through with regards to whether they've been through cancer. I've always just told them that it doesn't matter whether it's viewed as cancer or pre-cancer. There's no contest there. I'd happily give up my IDC badge if I could. None of us have the same experience in breast cancer land, just know that you went through a lot and you did it to be here as long as you can. 

As for other parts of your post. It's likely the reason you're not on Tamoxifen is because you had a BMX. If you hadn't, you probably would be. I will say that even though I may not agree with her style, I understand her concern. As someone diagnosed with TNBC at 34 and then found out I am BRCA1+, I'm playing the odds right now of trying not to wait too late to remove my ovaries before I develop ovarian cancer (my risk is 55%), and trying to balance that with reducing the substantial risk of heart disease and bone loss if I remove my ovaries very early. I passed my BRCA1 mutation to my daughter. She's 20 and just had her PBMX in March. She sees a gynecologic oncologist who wants her ovaries out absolutely no later than 32 because our mutation is so dangerous. His stance is if we don't remove our ovaries, we won't live long enough to have that heart attack anyway. Your GYN may have come off in a rough manner, but her concern for your heart and bone health are part of her specialty if those risks are related to your hormones created in part by those female parts she's tasked with monitoring. The position you're in with regards to HRT after DCIS and TAH/BSO is one lots of women face. Perhaps it would be best to see if your MO could consult with a Gynecologic Oncologist and determine the best way to protect your heart and bones while not increasing your risk for breast cancer issues? 

Best of luck.

I can certainly understand your exasperation and concern. It sounds like you didn't know before your meeting with the GYN that there was a debate about whether DCIS is cancer or pre-cancer. If so, that can catch you off guard if you didn't know there was a school of thought that differed; and it's certainly not a nice way to find out that info. I feel for women who have had invasive treatment for DCIS, but still have question (either their own or because of someone else) about whether they had cancer or not. It's a tough spot and as I said, we see a lot of that debate here on BCO. Really, the only treatment option that is different between DCIS and invasive cancer is chemo--which is never given for DCIS. I think eventually, DCIS will be split into 2 or more categories with the more aggressive version retaining the DCIS name and the more indolent versions getting a name that removes carcinoma from the classification. LCIS has a similar situation, but even though carcinoma is in the name with it, the great majority agree it isn't cancer, but rather a high-risk condition. 

I'm an avid (rabid?) genealogist, and I've since discovered a shocking amount of heart-related deaths in one line of my tree. Figures that I have this extra-rare BRCA1 mutation, yet no family history. But no known genetic heart conditions, and my family tree in one line is riddled with heart-related deaths. Part of that is what's worrying me about having the BSO. We do the best we can with what we have. That's what you're doing. I'm sure your GYN  was coming from a place of concern; it just sounds like she wasn't so good at expressing it.

Not to be nosy, but with the breast and ovarian cancer in your family, have you gone for genetic counseling? 

A negative result, while relieving, can also be frustrating if you see a clear history and don't have answers for why it's happening. If you're talking about the full BROCA panel from the University of Washington, I think it's a good move and I wish you the best of luck.