Which adjuvant chemotherapy regimen would you recommend for a peri-menopausal woman with synchronous stage IA primary breast tumors, one that is ER+HER2+ and the second ER+HER2-?

I would treat the patient with paclitaxel 80mg/m2 x 12 weeks plus trastuzumab for a year (Tolaney et al., Clin Oncol 2019). The more difficult question is the optimal anti-estrogen therapy: tamoxifen (TAM), TAM + ovarian suppression (OS), or aromatase inhibitor (AI) + OS. This is because the SOFT an...