Atypical hyperplasia

I was diagnosed with breast cancer in 1994.  I had radiation, chemotherapy. I was on tamoxifin (tamoxifen) for five years. I have now been on Evista since last June.  I recently had a biopsy for a lump on my other breast. Results were cells with atypical hyperplasia.
My doctor is hesitant to put me back on tamoxifin (tamoxifen) as the side effects can cause uterine cancer but this condition puts me in a high risk for another bout with breast cancer.  Do you have any information as to which would be the higher risk, a return of breast cancer without tamoxifin (tamoxifen) or uterine cancer if I go back on tamoxifin (tamoxifen)?   Thank you

[CCF-RN,MSN-JS]

Dear Peggyn, Unfortunately there is not a straightforward answer as to what would be the higher risk.  The data regarding treatment with Tamoxifen in the adjuvant setting (as you had after the first breast cancer) demonstrated clear reduction in the development of cancer in the opposite breast.  From this data the studies proceeded to use Tamoxifen in women at high risk for breast cancer.  Again there was a decrease seen in the number of breast cancers developing.  It was in these trials they saw the slight increase in the side effects of blood clots and uterine cancer however this increase was seen mainly in women over 50 years old.

It is difficult to know what the correct decision is.  Continue the discussions with your doctor to examine the risks and benefits in your individual situation.