Collect as much information as possible before you make a decision. As you are in perimenopause the lupron may not be needed for too long. I am on tamoxifen too and have concerns about uterine cancer but I’m at a lower risk.
Have you had BRCA testing, affects uterine cancer risk?
I’ve been reading about how Salpingectomy, removal of the fallopian tubes, lowers ovarian cancer risk, link below. It seems to be a laparoscopic surgery and much simpler than a hysterectomy. If I were younger it’s something I’d consider. I’m 69 and was diagnosed with BC when I was 17 years post menopause. Might be a talking point with your oncologist.
Also, compare long term physical effects of tamoxifen and AI, if you were considering that an AI would lower your uterine cancer risk. I think we’re still in the early years of determining what “no estrogen” does to a body after, say, 30 years. I see lots more research lately about estrogen’s effects on the entire body, including the brain.
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/04/opportunistic-salpingectomy-as-a-strategy-for-epithelial-ovarian-cancer-prevention#:~:text=By%20performing%20salpingectomy%20when%20patients,of%20ovarian%20cancer%20is%20reduced.