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Amelia,
My understanding is that in Her2+ ER+ patients, the "cross talk" as they call it allows for stimulation of the cancer in multiple ways, whereas there are fewer stimulation pathways in Her2- patients. Using Tamoxifen to block ER stimulation can push the Her2+ cells to more active signaling, to give the cancer an alternate pathway to grow through. One of the studies I cited in the link above said that this force was so strong in some patients, if clinical trials utilizing Tamoxifen were to be designed, it might be prudent to treat even Her2- patients with a Her2 blocker, to prevent this alternate signaling from occurring.
Whether or not to take Tamoxifen is a decision you need to make with your doctor. For myself, all of the reading I have done on this topic has made me leery of not just Tamoxifen, but anything (foods included) that can act like a SERM.
Hopeful
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