Based on TAILORx, what will be your approach to a pre-menopausal woman with a recurrence score 16-25?

In TAILORx, women with intermediate recurrence scores (11-25) did not benefit from chemotherapy. However, an exploratory analysis suggested some chemotherapy benefit for women age less than 50 (compared to older than 50) with recurrence scores of 16 to 25. Therefore, many would suggest that premenop...

I would favor hormonal treatment with ovarian suppression as it does not make any sense to me how an age difference will make the woman benefit more from chemotherapy except for role of ovarian suppression by chemotherapy . I would be open to giving chemotherapy if patient wants it.

Offer chemotherapy

Additional benefit of ovarian suppression (plus endocrine rx) was seen in those who had received chemo and then remained premenopausal (per SOFT trial).

I tend to offer chemo for premenopausal patients w/ RS 16 to 25, understanding that the maximum benefit of chemo was due to indirect ovarian suppres...