Would you recommend any adjuvant therapy for a premenopausal woman with ER+, microinvasive breast cancer who cannot tolerate tamoxifen?  

I would explain that the benefits of tamoxifen are low, but it may help prevent a new cancer. If she has arthralgias before stopping treatment she may want to try acupuncture to see if it helps her with her symptoms. If she still does not tolerate it she should focus on lifestyle factors such as exe...