What is the optimal management of Krukenberg tumor in a pre-menopausal woman with HR pos metastatic breast cancer, progressed on Tamoxifen and second line Gemcitabine, with the rest of the disease sites well controlled?  

If the Krukenberg tumor is the only site of metastasis or active disease in a premenopausal patient with HR+ metastatic breast cancer, I will recommend a complete surgical resection of the tumor together with B/L oophorectomy to render her surgical menopausal.  There is no definite data to sho...