Hi mazzabayes, Only we can make that decision. I’m 76, haven’t really a clue how low/high risk I am, didn’t have chemo just 5 sessions of radiotherapy, so telling myself I may be low risk. I’ve chosen not to take Tamoxifen because I feel fit & healthy again now and prefer to feel like that & do not want to tolerate any side effects. I’ll have to face it if I have a recurrence, it’s just scary that if it comes back it might not be curable, which is what I’ve been told is likely if I don’t take Tamoxifen, but I’ve read on here ladies have taken it & it has still come back & some, not all, have suffered awful side effects in the meantime taking blockers & had a miserable time. We all have to go sometime! Whatever you decide I hope it works out for you.
The only side effect I have had on tamoxifen is night sweats - bad for 4 weeks but settled after that
You may have no side effects- everyone responds differently
Hi hiker50, Yes, I know lots of women don’t have any problems taking Tamoxifen, this is a personal thing with me, I never take anything, except an occasional Paracetamol. I’ve read up on all the side effects ‘that are possible, but unlikely’ but still can’t take it. I have considered trying it, but just haven’t got to the stage of actually doing it. Obviously, I really hope I won’t regret my decision.
We all decide what we are personally comfortable with and will never know how a different decision would have turned out, unfortunately.
I had my surgeon tell me I needed chemo for the best chance of survival (pre and post op) so mentally prepared myself for 10 weeks before seeing the oncologist & being told she was not recommending it. I was then told it was up to me 
I decided against based on oncologist’s justification for her suggested treatment with RT, herceptin & tamoxifen
If it comes back, I’ll always think I should have opted for chemo but I was told my prognosis is so good she felt the risks of chemo weren’t worth it
Let’s hope we are all lucky & don’t have any recurrences. I wish you all the best for the future.
Hi @mazzabayes this is a decision many of us struggle with. I will be 69 in five weeks so roughly at the same stage of life as you. I have taken Letrozole for two years (of 5) but with some self-determined breaks during that time. I am lucky, I’ve never had the joint and muscle pain that you have had on it or hot flushes (never had those during menopause so I guess it figures) but I do get very bad periods of fatigue and brain fog. I argue with myself every day during the fatigue, whether to just stop it. There is a very long list of pros and cons that I tediously go through during this argument but it all comes down to one thing - if I choose to not take the drug and was to develop secondaries, could I live with my decision? Additionally, if I decided not to take the drug, would this desired quality of life be negatively impacted by fear of secondaries? If I could answer yes to the first and no to the second then I’d choose to stop. If not, in your position, I’d choose to give Tamoxifen a try with the option of stopping later. There is a large percentage of women who do stop, particularly amongst those of us later in life - and I may well become one of them - so you would not be alone in that decision. Ultimately no-one can foresee the future so it comes down to how risk averse you are.
Here is a link to a long consideration of this point that you might like to dip in to. I wish you strength and luck in making this decision.
I follow this website a lot to see if anyone posts to say they chose not to take Tamoxifen, as I myself have chosen not to do, but the posts are rare. I haven’t read any where Tamoxifen has been declined and there has been no recurrence. I haven’t changed my mind about even trying it though, hate the thought of what it can do.
I think because the vast majority of women who take Tamoxifen are younger, mainly premenopausal, and therefore a) tend to be impacted more adversely by BC and b) are likely to have young families, they are more likely to take the “throw everything at it” approach so plough on even if they have side effects. Tamoxifen is older technology, works differently to AIs and has very different potential side effects to AIs, most of which are less impactful on a day to day basis so it would seem has a better take up than AIs. There is also the occasional thread on here involving women who have reached the end of their Tamoxifen programme and want to continue it because of the reassurance they get from it, so there is a very broad spectrum of responses to it. For what it’s worth, I think your decision to not take Tamoxifen is a very understandable and relatable one.
I used the new Predict app & taking Tamoxifen gave me a 1% better chance of survival over 5 years, I’ll be 81 then, so I’m just trying to stay optimistic & healthy.