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Tx PMW ER+/HER2-neg, asymptomatic mets after 1 year adj AI?

What would you generally recommend for a postmenopausal patient with ER-positive/HER2-negative disease with asymptomatic, low-volume metastases after receiving adjuvant anastrozole for 1 year?

Baselga J et al. Everolimus in postmenopausal hormone-receptor-positive advanced breast cancer. N Engl J Med 2012;366(6):520-9. Abstract

Bergh J et al. FACT: An open-label randomized phase III study of fulvestrant and anastrozole in combination compared with anastrozole alone as first-line therapy for patients with receptor-positive postmenopausal breast cancer. J Clin Oncol 2012;30:1919-25. Abstract

Cardoso F et al. A review of the treatment of endocrine responsive metastatic breast cancer in postmenopausal women. Cancer Treat Rev 2013;39(5):457-65. Abstract

Di Leo A et al. Final analysis of overall survival for the Phase III CONFIRM trial: Fulvestrant 500 mg versus 250 mg. San Antonion Breast Cancer Symposium 2012;Abstract S1-4.

Mehta RS at al. Combination anastrozole and fulvestrant in metastatic breast cancer. N Engl J Med 2012;367(5):435-44. Abstract

Peto R. Results from the ATLAS trial of 5 versus 10 years of adjuvant tamoxifen for women with ER-positive breast cancer. Breast Cancer Update, Issue 1, 2013. Available at: http://www.researchtopractice.com/BCU113/sir-richard-peto/results-atlas-trial-5-versus-10-years-adjuvant-tamoxifen-women-er-positive-b

Robertson JF et al. Fulvestrant 500 mg versus anastrozole 1 mg for the first-line treatment of advanced breast cancer: Follow-up analysis from the randomized 'FIRST' study. Breast Cancer Res Treat 2012;136(2):503-11. Abstract