Recurrence and Chemo

I am a 53 yr old who had a ductal carcinoma 3 years ago.  I had a lumpectomy, (1 of 10 nodes had cancer), followed by chemo (CMF-8 treatments) and radiation.  Then I started on tamoxifen which I still take.
I underwent a mastectomy this week for a 1.4 tumor recurrence in the same spot.  No other cancer in breast.  Four nodes were taken and were clear.  All C.T. tests, bone scan, chest x-ray and blood work were good.  My question is - Do I need to have chemo again?
My oncologist has suggested AC.  I am afraid of heart complications.I have a strong family history of heart problems.  How will taking this improve my chances? What percentage?  Is it worth the risk?
My surgeon has hinted that the radiation failed - not the chemo.
Are there other things I should be taking instead of tamoxifen?
If I have a metastactic cancer later- is it true that I would not be able to be treated with Adriamycin again? I don't want to do chemo again as just a precautionary measure but if it is needed I will. I'm afraid of other serious things it might to do me.  I am also non-insulin dependent diabetic.

[CCF-RN,MSN-JS]

Dear AnnMarie, There is not a direct answer as to whether or not you need chemotherapy again.  The decision to do so will need to take into account your personal situation and risk factors, weighed against the benefit

[Colonel]

I am a male with breast cancer and also a liver transplant recipient.  Had a masectomy and 11 nodes out of 18 were positive.  Chemo is a big risk because to my liver.  Could I only take hormonal therapy like tamoxifen or other type of drug or what that not be effective.  Don't know whether cancer has metasitized.  Thank you.