It makes sense for you to weigh this decision. I've been on letrozole for almost four years with no side effects. Of possible interest to you, my oncologist said this might be because I've been dealing with chronic pain for decades and have good PT, exercise, and medication in place. You can of course just try letrozole and see. But if the oncologist says fine to skip that obviously would be an ok choice as well. Hope you get some specific info here.