How would you approach adjuvant endocrine therapy in a previously premenopausal patient with ipsilateral recurrence while on OS and AI, 2 years after receiving ddAC-T chemotherapy and adjuvant radiation?
Originally oncotype score was elevated with first occurrence. The recurrent cancer is 2 cm, node negative, and the receptor status is a strongly ER positive, PR negative, her2 negative breast cancer. Estradiol levels are undetectable currently. Would you send NGS? Would you consider tamoxifen+abema+OFS?