I know this is an old post, but I’d love to weigh in on this topic! I’m a 47 year-old white female, diagnosed with HR+ HER2- Stage 2A breast cancer in August 2021. After a lumpectomy and sentinel lymph node biopsy, chemo, and radiation, I started taking Anastrozole (along with a monthly injection of Zoladex because I am pre-menopausal). It was great until two months in, when my thumbs began locking. I learned it was called trigger finger, and it got progressively worse quickly, and was painful, but not intolerable. I also experienced joint pain and aches in my legs, but it was also tolerable. When my thumbs got to the point where I had to actually unlock them from a bent position using the other hand to pop them straight, my doc and I decided to take a break from Anastrozole and then try letrozole. My trigger thumb rapidly improved, but immediately returned when I began the letrozole. We then decided to ditch the AIs and go to tamoxifen. Once again, things were fine for two months, until I was walloped with sudden and severe anxiety followed by depression. I am lucky to have never experienced either before, but for the next two months I was absolutely miserable and unrecognizable to my family and friends. I can’t find any medical studies on this, but my brother unearthed a ton of anecdotal evidence that tamoxifen can cause severe anxiety and depression. My doctor gave the ok to quit the tamoxifen, and my symptoms disappeared within a week. I was entirely back to my old self, thank goodness. Interestingly, a friend (only 30 years old) went through the exact same thing when she took tamoxifen a few months after I did. I’d love to see this link between tamoxifen and anxiety/depression studied; I feel the medical community completely ignores this very serious issue, even though it seems awfully common. Since I am at high risk of recurrence, we didn’t want to abandon hormone therapy entirely, so I started the third AI, exemestane. So far it’s going great, no trigger thumb or joint/leg pain yet, although I am just now at the two-month point that seems to be my tipping point. I’m really hoping for the best, especially since my doc recommends ten years of hormone therapy to reduce the risk of recurrence. I will say that I would take trigger finger over the depression and anxiety caused by tamoxifen any day. I am a little worried that if the trigger finger returns and worsens, I will require surgery to fix the problem, but right now I’m just praying the exemestane works without issue! This was a long comment, I know; thanks for reading!