My partner (41 ER+ Stage III+) has decided against use of Tamoxifen as a SERM and instead take bio-identical hormones, including 2-methoxyestradiol, estriol, progesterone, DHEA and testosterone. Specifically, we understand 2-MeOE2 to have SERM properties, but also be specifically anti-carcinogenic. See http://lib.bioinfo.pl/pmid:15156405 as one of many publications.