Is combined tamoxifen plus hormonal therapy better for breast cancer in pre or postmenopausal women?

Need to know: Er/pr receptor status on resected tumor, as if these are negative, no role for hormone therapy. Post orpre-menopausal er+ patients are treated with the effective, cheap, low adverse effect tamoxifen, a useful drug for more than 30 years. But ovarain function precluses use of anastrazome or the newer more expensive letrozole. These all work; toxiicty and cost vary.

Hormonal treatment: In general, tamoxifen is used for premenopausal women and aromatase inhibitors are used for postmenopausal women.

Estrogen supression: In general, aromatase inhibitor is only indicated for postmenopausal women ;not for premenopausal; while on the other hand, tamoxifen can be given either in pre or postmenopausal. Only thing is that tamoxifen can cause a little bit higher risk for complication -i.e. Risk for blood clots and risk for develping uterine cancer- when used in older population- age of -65 Y.O. Or above.