How do you decide whether to offer tamoxifen or OFS + AI in premenopausal patients with metastatic ER+ HER2+ breast cancer as your endocrine therapy?  

In general, for node-positive premenopausal women, I use AI and OS. For node-negative patients, I generally use tam + OS for oncotypes 16-21 (the group where we saw a 2% benefit from chemo in TAILORx) and AI + OS for oncotypes 21-25 (where we saw a 7% benefit from chemo in TAILORx). It seems from SO...