How would you treat a patient with a known history of ER/PR 90% and HER2 negative who develops skeletal metastatic disease on adjuvant endocrine therapy but now ER is only 2% and is PR and HER2 negative?  

Initially stage 1 disease with high risk Mammaprint recurrence risk completed adjuvant chemo 15 months ago. 



Answer from: Medical Oncologist at Academic Institution