What do you advise young low-risk pre-menopausal patients requiring adjuvant hormonal therapy who have endometriosis and are worried about the effects of Tamoxifen?

This is a situation where risks and benefits must be weighed for each scenario so the providers (gyn,med onc) and patient can make the therapy decision together. Low risk can mean different things and that can influence the decision for therapy. Is it low absolute risk with (T2N0 low oncotype dx) or without endocrine therapy (3mm IDC)? If she needs endocrine therapy but can't take tamoxifen, then ovarian suppression alone (EBCTCG LANCET 1996) will not worsen her endometriosis if she is deemed no...