How would you treat a premenopausal woman with triple positive breast cancer that has not had any therapy with a bilirubin of 10mg/dl due to intrahepatic disease?  

Your chemotherapy options are limited but you can give some agents like xeloda with herceptin/perjeta as induction then switch her over to endocrine therapy (ofs + AI) plus herceptin/perjeta like the PERTAIN trial. If you can't give her those agents another option that has pulled some patients out o...