Complexities of adjuvant endocrine therapy in young premenopausal women.

Overall, this excellent overview of management issues for breast cancer patients under 40 years of age highlights the major questions surrounding choices of adjuvant systemic therapy. Treatment choices are dependent on breast cancer biology (receptor status) as well as patient factors (ovarian function and desire for future fertility). As many unanswered questions remain, it is important to continue to enroll subjects in clinical trials focused on this important patient population.