How would you approach adjuvant endocrine therapy after excision of a hormone positive recurrence after mastectomy who finished 5 years of aromatase inhibitor for the same primary tumor?   

The key question is whether this is an endocrine-sensitive or endocrine-resistant disease. If this recurrence happened after discontinuation of endocrine therapy, then most likely it is because of withdrawing therapy that was effectively suppressing the disease. This is not an uncommon scenario, and...