Would you offer adjuvant chemotherapy to a premenopausal woman with HR+ HER2 negative IDC, T1cN0, with isolated tumor cells, oncotype RS 20, grade 2, with multifocal LVI?   

First - isolated tumor cells have no clear impact on prognosis and should NOT be used to alter local or systemic treatment decisions. The TAILORx trial unplanned subgroup suggested a small but real benefit from chemo. However, very few (11%) of premenopausal patients got optimal HRT that included OF...