Hello @jpnnobx -- I agree with everything Chris suggested. I have been on Letrozole and Kisqali for 2 years now post recurrent breast cancer chest wall surgery and radiation. Mine is PR+, HER2-, definitely hormone driven. Ki-67 50%. Chemo not recommended because of pre-x neuropathy. He's not sure chemo would be beneficial for my cancer anyway. Had a double mastectomy in 2013. He said we would revisit the treatment plan based on latest data at the two year mark so at my visit later this month. I like the security of being on the meds despite the side effects. I'm wondering if you should also be on a CDK 4/6 inhibitor like Kisqali or Ibrance? I'd love to know what a cancer center or university has to tell you about meds. Also be sure you have a breast oncologist rather than medical (general) oncologist. Breast cancer experience counts. My breast oncologist is part of UCLA so he should be up on the latest data and treatment plans.