2nd May 2024

A 67-year-old woman presents with a newly discovered lump in her right breast.

A 67-year-old woman presents with a newly discovered lump in her right breast. Her past medical history includes hypertension, controlled with amlodipine, and osteoporosis, for which she takes alendronate. She underwent a menopause at the age of 51. On examination, there is a 3 cm, hard, non-tender lump in the upper outer quadrant of the right breast, with no skin changes or nipple discharge. No axillary or supraclavicular lymphadenopathy is noted. A core needle biopsy of the lump is performed.

Investigation:

Pathology report of breast biopsy: Hormone receptor-positive, HER2-negative invasive ductal carcinoma

Considering her postmenopausal status and the hormone receptor-positive, HER2-negative nature of the tumour, which is the most appropriate initial management?