Letrozole or Tamoxifin?

Background: 52, large tumour, minor lymph involvement, single then double mastectomy. Letrozole was advised as more effective for my high risk tumour (big & aggressive) - I have normal bone density but even so bone strengthening is recommended as a preventative for bone loss and because the combination is seen to work better than Letrozole alone for my subtype (ER/PR+ HER2- high risk).  I've also not yet started bone strengthening as my teeth are not yet stable/am sure I wouldn't need an extraction. If you find yourself choosing Letrozole, do make sure to let your oncologist know about your pain levels and try to walk daily if you aren't able to exercise (I play squash 3x a week + walk). I suffered for several months and worried myself with fear of a recurrence due to the intense pain I had initially in my legs. I suggest you arm yourself with a script for Codeine from your GP at the start - after 2 months, I now take Panadol Osteo 24*7 to control bone pain as my feet hurt to walk on otherwise (in their words, it's the lesser of 2 evils). I do suffer from extreme bone pain events about twice a month where it's uncontrolled, usually preceded by me lying in bed for a while or sitting for a long time esp driving.  My oncologist has given me Palexia to manage it as codeine takes 20-25mins and I am unable to do anything when those events happen. Having said all that, beyond sudden intense tiredness a few times per month, standard medical menopause side effects and the occasional pain event, it has improved over the last 6 months and is mostly manageable. Good luck with your decision and be sure to get plenty of advice from your oncologist, surgeon, breast cancer nurse, here and your GP - and always remember asking about the possibility of reducing a dose/duration, taking a medication holiday or trying another option.