@kcalhoun So glad the weight issue cane up! I do a lots of research as well.
Two issues I can’t find enough definitive research on, is fat/weight, and, actual risk of dcis with a papilloma in the peripheral breast (my type) vs central nipple area. It seems papillomas in the outer areas of the breast tend to come in multiples whereas papillomas near the nipple are usually single. Papillomas are usually benign but often aligned with ADH, which can be a precursor for cancer. The oncologist agrees. But the answer seems to be, just keep getting scanned. I keep hoping new research will come out with better outcome info. But this is one reason I chose to do tamoxifen.

The fat/weight issue - it just seems odd that knowing that estrogen is present in fat that that wouldn’t be a super high risk for hormone positive cancer. And as you said, AIs tend to cause weight gain, with tamoxifen not far behind.
“Lower estrogen directly decreases Resting Energy Expenditure (REE) and total energy expenditure.
Estrogen deficiency causes fat to shift from the hips and thighs to the abdominal region (visceral fat), which is metabolically less active and linked to insulin resistance.”
3 1/2 years into low dose tamoxifen I’ve started gaining weight, partly stress eating over family medical/care issues. And having a terrible time losing it. I believe its becuase my metabolic rate has tanked. If fear of scans is scanxiety then I’m feeling bc pfatxiety! I haven’t put on enough weight yet to consider GLP-1 but I’ve got to stop this progression.