Would you consider a treatment holiday in a patient with HR+ oligometastatic breast cancer who is in a prolonged remission?

Obviously, we have little data to guide our approach here. However, I would feel a bit uncomfortable holding the patient's AI but would consider it in certain situations, such as the patient having toxicities that are difficult to tolerate. In that situation, I would consider an alternative endocrine agent after a holiday. If there are toxicities that endanger the patient's well-being, such as advanced osteoporosis and vertebral compression fractures, I would carefully weigh the risk/benefit rat...

I agree with the fact that there is little evidence to guide medical decision making in this particular case. This would constitute an ideal case whereby circulating tumor DNA could potentially inform medical decision-making.
The dichotomy between metastatic versus nonmetastatic disease is seriously challenged nowadays. Although a uniform definition of oligometastatic disease is still vehemently debated, it is increasingly recognized that oligometastatic disease has very diverse underlying biolog...

If she is tolerating treatment and has no complications from it, I would continue. If she has significant side effects and wanted to stop, I think that would be completely reasonable.

I do agree with @Dr. First Last that sometimes getting surveillance imaging covered in these cases can be challenging, but certainly not impossible. And if there were clear evidence of progression, I would biopsy and NGS test it before restarting therapy.