Can't take medication, unsure of options.

Celand, reading about your situation, the question for me would be "what is the distant recurrence risk you face with no additional treatment?"

It appears that you had a small (<1cm) grade 1 tumor that is HER2-. What makes your staging Stage IB versus Stage IA? Did you have any nodal involvement? And did you have an Oncotype test done? How large was the invasive portion of your tumor? - that determines both the staging and whether an Oncotype test would be appropriate.

While your MO is the doctor who should be giving you information about your risk level and the benefit from Tamoxifen or an AI, there are computer models out there that provide a good estimate. Here's a link to one of them:

http://www.lifemath.net/cancer/breastcancer/therap...

Generally, endocrine therapy (Tamox or an AI) will reduce distant recurrence risk by approx. 1/3. I don't have all your information, but when I input the info you have provided - age 51, tumor size of 1cm (I'm assuming the 1cm is all invasive - the DCIS portion should not be counted for this model), ER+, PR+, HER2-, grade 1 and then assume that you were node negative, the 15 year cancer mortality rate is 4.4%. This is the result with no chemo and no endocrine therapy. When I add in hormone therapy, the 15 year cancer mortality rate goes down to 3%. So hormone therapy provides only a 1.4% risk reduction over 15 years.

The numbers are a bit different if you are node positive. Inputting the same information but adding in that there was 1 positive node, the 15 year cancer mortality rate is 11.2% with no chemo or endocrine therapy. By taking an AI, this is reduced to 7.6%. So if you are node negative, then the risk reduction benefit from hormone therapy is 3.6%, which is certainly more compelling.

I'd say that before you start looking for other risk reduction treatment options, you should be sure that any treatment is worth it to you, with consideration to the side effects and based on how much it can reduce your risk. As dtat points out, both weight loss and exercise have been shown to reduce recurrence risk. Given your other health issues and your seemingly very favorable diagnosis (particularly if you were node negative, which is unclear), that might be sufficient to bring your risk down to about as low as it can be with any invasive cancer diagnosis.

celand - something you might consider is doing a BCI (Breast Cancer Index) test. This is a genomic assessment (done on removed tumor material preserved after your surgery) at the five year point to help determine whether to continue taking anti-hormonal meds beyond that. I mention it because the test result provides information on both recurrence risk and effectiveness of the medication on your tumor. This could add to the conversation if your risk is low and the benefit from the drug is also low. Even though you are not at the five year point yet,doing this test early might provide information that helps you make decisions and/or provides some peace of mind.

celand, I read about Salamandra who is taking farestronan alternative. Don't know much about it. I'm currently struggling really bad with AIs and don't know what to do. Dr appointment tomorrow.