27th February 2025

A 67-year-old lady presents with a right-sided breast lump and newly inverted nipple to her GP. She is a current smoker of 10/day

A 67-year-old lady presents with a right-sided breast lump and newly inverted nipple to her GP. She is a current smoker of 10/day. She has no family history of breast cancer. Her past medical history includes COPD for which she takes a once-daily Trelegy (fluticasone) inhaler. She is independent with activities of daily living.

She is sent to a one-stop breast clinic where she has an urgent mammogram which demonstrates an irregular 2.5 cm spiculated lesion in the right upper quadrant of the left breast. Axillary ultrasound shows two enlarged lymph nodes which are biopsied and confirmed to be cancerous. A CT chest abdomen pelvis demonstrates no metastatic spread. The histopathology report describes a grade II tumour which is ER positive, PR positive and HER2 negative.

What is the most suitable management plan for this patient?

Select the SINGLE most appropriate option from the list below. Select ONE option only.