Abstract
An otherwise healthy 53-year-old woman is seen for routine care after completing treatment several months earlier for stage II estrogen-receptor–positive, HER2-positive breast cancer. The treatment consisted of lumpectomy, irradiation, adjuvant chemotherapy (doxorubicin and cyclophosphamide followed by paclitaxel), and trastuzumab. Her only current medication is an aromatase inhibitor. She is amenorrheic. She reports fatigue, hot flashes, arthralgias, and sexual difficulties and is concerned about the risk of a recurrence. How would you follow this patient, and what would you recommend for her symptoms?

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