How would you approach a patient with early stage breast cancer on adjuvant docetaxel that developed lacrimal duct obstruction after 2 cycles?   

If a patient has already developed one duct requiring stenting I would probably discontinue the docetaxel and substitute paclitaxel or nab-paclitaxel, which do not appear to have similar ocular toxicities.  This is uncommon with q3wk administration of docetaxel but is drug-specific and your pat...