Atypical Hyperplasia hormone concern

It certainly sounds like mixed signals. Everything I know about this condition is that it is pre-cancer. It also increases the risk of breast cancer, that could certainly account for the doctors wanting you to limit hormones. There is even someone on one of these support pages who mentioned taking endocrine therapy to further reduce hormones.
Here is a link to the page Mayo has about ADH.
https://www.mayoclinic.org/diseases-conditions/atypical-hyperplasia/symptoms-causes/syc-20369773#Overview
The horrible part of dealing with cancer (pre-cancer) is trying to second guess what it will or will not do in the future. Even a mastectomy is not fool proof. Even the radical mastectomies of the past were not fool proof.
Have you discussed this with the oncologist or just the surgeon?

We have. Thank-you for your input.

I think catching the ADH was your warning sign. I definitely would not continue HRT. That just feeds any potential growth of cancer.

If it’s a warning sign how are you to proceed and need the warning? What do people do? Need advice and help. AIs seem to only reduce quality of life. Mastectomy seems overkill for a 15% lifetime risk. Do folks just monitor closely? Want opinions please

Many women can easily tolerate AI. My sister was on one for 10 years--pre-menopause--with zero symptoms. I've been on letrozole since November with only a few mild hot flashes. Why not start on an AI and then come off it if intolerable? It is worth giving it a shot, I think, sit is a good defense against breast cancers.

Yes, I believe it is the warning bell. Because it is a pre-cancer accumulation of cells. The link above talks about intensive monitoring.
Yes, AI drugs can reduce your quality of life, then again, many women take them with no trouble at all. Cancer can certainly disrupt your quality of life too, if you land in that 15% . My risk of getting breast cancer was around 3%, that didn’t matter when I was going through chemo.
Every treatment decision has to be a cost vs. benefit decision for each person.
Talk to your doctor, find out your options, then at least you can think about what is important to you. Age can be a big factor in deciding this. If you are 35 that 15% might feel different than if you are 75. How active are you, and how active do you plan to be. None of this is easy, sigh.
Do you have an appointment to discuss your options with your doctor?

Thanks very much.

Yes I’d say you continue to monitor closely. ADH is not cancer. It’s abnormal cells but it’s still a few steps away from actual cancer.

It seems like there’s some confusion here about exactly what medication you are talking about. I’m gathering you are talking about HRT which increases hormone levels and would continue to feed any potential cancer. It sounds like some think you are talking about aromatase inhibitors which would stop the growth. Personally I would discontinue any use of HRT and monitor the breast. A mastectomy would not be any guarantee so I don’t think you should be second guessing that. People can still have a reoccurrence even after a mastectomy. Cancer can show up in the scar tissue or just go right to the ribs.

Are the cells Estrogen positive? If they are not, you might not need to stop HRT.