Hi Nas, I'm so sorry this is dragging on & on for you. It's a really difficult situation for patients & doctors alike. The medics (GPs, Menopause specialists etc) who have it within their power either to prescribe HRT for women who have had breast cancer, or to give their blessing (Oncologists, Breast Surgeons etc) for another medic to do so, also have a duty of care to ensure they do nothing to cause harm. In addition to the ethical position, the thought of giving the go ahead may be personally horrifying - they will care about what happens to their patients.
I really feel your frustration & anger, which is why I think I flagged up on your earlier thread the Avrum Bluming book CLKD is also referring to. I imagine you read this but can't remember for sure. His views are very encouraging & in theory somewhat liberating for breast cancer patients in need of HRT, but it may take years for them to filter down to other medics & there may still be many who are resistant to the idea that HRT can ever be safe after breast cancer. I really hope you manage to thrash this out with a medic who knows your history & can help you reach the right decision, but just wanted to say that the reluctance you've come up against is almost certainly due to their feeling they have your best interests at heart. I'm not saying they're right - I just want you to feel less bad about the hurdles you are facing.
CLKD - I'm aware of your history from your past posts & am pleased you have done so well, but not sure from your comment about bilateral mastectomy whether you know that such radical surgery still doesn't guarantee breast cancer will not recur. The choice between lumpectomy & mastectomy will depend upon a number of factors, including size, type & stage of tumour, whether there is more than one cancerous area present, breast size relative to tumour size & in some cases the patient's preference. Even after mastectomy there can be local recurrence in skin flap, nipple (if spared), chest wall or scar tissue & possibly distant recurrence elsewhere in the body if the original cancer was invasive. These days the trend is for breast conserving surgery where possible - i.e. lumpectomy with/without or Radiotherapy &/or Chemo & possibly hormone blockers, where these various adjuncts are appropriate. Mastectomy is a bigger operation, possibly carrying more risks & may also require more time in hospital than lumpectomy. So in addition to clinicians wanting to conserve as much as possible of the breast in a smaller procedure, for a better cosmetic outcome & less trauma for the patient, there are cost considerations as to why mastectomy may not be recommended. This is a bit of a meander, but there is sometimes the assumption that mastectomy guarantees a future free of breast cancer & sadly this is not always the case. I wasn't sure from your comment whether that was what you thought.