That would depend on your age, stage, and grade as well as the type of breast cancer.

Prior to AI's, everyone took tamoxifen. I tolerated it better than the AI.
AI's only provide a very slight improvement in recurrence rate. So many have osteoporosis issues from the AI's, tamoxifen actually improves bone mass, but can increase risk for blood clots and uterine cancer.
Both have their side effects.
May want to research DIM. And speak with your doctor about it.

Hi Catlovercarla! You are stage 1, over 50 and Er/Pr+, all of which are in your favor. It is important that you also know your GRADE. If your are Grade 1 then AI are not terribly determinative of outcome. If you are Grade 3 then you may get much more benefit [statistically speaking) from them. In the end the decision is what are YOU comfortable with. I am Stage 1, Grade 1 and very comfortable not using tam or AI. I also am already riddled with arthritis thanks to being hit by a car 30 years ago......just to be clear, I was a pedestrian. Anyway, these are my choices and I know that if/when it catches up with me again I may have some regret. I’m going that direction nonetheless. You specifically asked about alternatives. That question has previously been asked on this site and you might want to search those Q/A’s. Options are: 2 tbsp freshly ground flaxseeds (get a small electric coffee grinder); 1-2 Tbsp Zone ultra pure fish oil (quality counts big here); high dose melatonin (20+60 mg) taken with high dose (5 IU) vit D nightly and sleep a full 7-8 hours in fully darkened room (or wear eye mask). Also consider modified citrus pectin 3x/day alone or with Breast Defend. Both are available on Amazon and are strongly supported by oncologists and PubMed research. Breast Defend is a supplement of mushrooms and curcumin among other useful ingredients and should be taken 2 hours separated from the modified citrus pectin. Modified citrus pectin sucks all kinds of foreign substances from your body including the galactin 3 enzyme that is needed for metastasis. MCP also seems to reduce any EXISTING tumor load. I find I need to separate it a good 2 hours from my meds or they too get sucked out of my system. I do all the above suggestions. Good luck Catlovercarla! Hugs, Judy in Ky

20 - 60 mg melatonin
MCP = modified citrus pectin
:) Judy

I see you also are suffering with horrible nightsweats. Done that, been there! Yucky stuff! Cancer Treatment Center of America and Vanderbilt Breast Center and MD Anderson all recommended 240mg magnesium glycinate/malate morning and night. It really helped but did take a week or so to build up in my system. If I’m having bad nightsweats I double the dose. I sufffered with those nasty sweats for about 18 months after double mastectomy and stopping my bio identical hormones. Here’s comforting news though: stats show that women whose nightsweats are the worst tend to have overall better survival than some others. Grin & bear it, I guess! Also cotton tank tops under sweaters or jackets give you options to peel out when it hits during the day. I practice law and have found that a fresh white tank top with a business suit and a little jewelry passes as “court room ready”. You can do this! You may have cancer but cancer does NOT have YOU! XOXOX, Judy in Ky

I was 71 almost 4 years ago. I.4 , stage 1, went flat because I didn’t want radiation. I was Onco 1 , no treatment. I refused the pill. Too old , bone on bone knees . I used Adjavant online.com to see my % of reoccurrence. I changed Drs and the new one agreed with me.