You sound as though you are really struggling.I am 59 and have a low BMI also.However I don't work 9 hours a day out of the home.There is another lady on this blog that stopped her hormone therapy early and had a recurrence.I am hoping that she may see your post and reply to you.What is it about Tamoxifen that scares you? I think that it is helpful for me because it has the added benefit of helping my bones which is what I really need.Looking forward to your reply.Cheers xoxRobyn