What first line therapy would you give a premenopausal patient with HER-2 positive and ER positive metastatic breast cancer with visceral organ involvement?   

This is a very good question. In the recently published SYSUCC-002 trial, trastuzumab plus endocrine therapy (ET) was not inferior to trastuzumab plus chemotherapy (CT) as first-line therapy for hormone receptor positive, HER2 positive, metastatic breast cancer. In this trial, 30% of patients were p...