How would you approach adjuvant therapy for a premenopausal female with HR+, HER2+ breast cancer with N1mic disease?

This is a difficult case; I see why someone posed the question.

I'd want to know more information:

- how old is this premenopausal women?

- what is the grade of the cancer?

- how many lymph nodes were removed?

With regard to adjuvant chemotherapy / anti-HER2 therapy:

My first thought, based on the fact...

Assuming that she has had breast surgery, the adjuvant chemotherapy that I would use in this is weekly paclitaxel at 80 mg/m2 x 12 weeks along weekly trastuzumab x 12 weeks followed every 3-week trastuzumab for a total duration of one year. This regimen with median follow-up of 6.5 years (Tolaney et...