I'm 62 and was dx with early stage dcis last summer. I had a lumpectomy followed by radiation and then began my hormone therapy with tamoxifen. My oncologist suggested a course of 'baby tam' which is 5mg/day of tamoxifen vs traditional 20 mg/day for 3-5 years. I did quite a bit of research on my own and looked at the studies and felt very comfortable going the baby tam route. I was also very concerned about tamoxifen but other than a recurrence of hot flashes it's been fairly smooth sailing. I so empathize with your fear and am sending a big hug. Take a look at the research into baby tam and if interested, ask your oncologist if it might be a good route for you. And as others have said, you can always start and if it's too much you can stop or switch to an AI.