What is your approach to adjuvant endocrine therapy in high-risk premenopausal women with ER/PR+ Her2+ breast cancer?

There are no large scale modern era assessing the role of adjuvant hormonal therapy in patients with HER2+ and hormone receptor positive breast cancer. Data from metastatic trials and cohort studies do suggest that there is an interaction with concurrent hormonal and HER2-targeted therapy and the tw...

As a follow up to this question, I wanted to share some points from the planned update after 9 years median follow-up of the combined analysis of TEXT and SOFT presented by Dr. Pagani at SABCS 2017. This joint analysis included 4690 premenopausal ER/PR+ patients, of whom 12% were HER2+. Among the su...

In the subset analysis for patients on SOFT with HER2+ breast cancer, tamoxifen in addition to LHRH agonist vs exemestane actually had an advantage. It is important to remember that tamoxifen is more preserving than full on estrogen deprivation and that you save more bone and joints, and perhaps car...

The young patients (<35) and those with HER2 positive tumors had the most benefit from complete hormonal blockade in the soft/text trials - however this is often very toxic for young patients and has long term effects on quality of life - so it really becomes a discussion about the risks and benefit...