How would you approach adjuvant therapy for large (≥4 cm), node negative, HR+, HER2- breast cancer in an elderly woman with comorbidities including neuropathy?

What is your preferred adjuvant therapy for elderly patients with comorbidities, and a large (≥4 cm), node negative, HR+/HER2- breast cancer?

• Chemotherapy followed by endocrine therapy
• Ribociclib with endocrine therapy
• Abemaciclib with endocrine therapy
• Endocrine therapy alone
• Depends on risk score: if high would offer chemo+ET / if low grade would offer ET alone
• Depends on risk score: if high would offer ribociclib+ET / if low grade would offer ET alone
• Depends on risk score: if high would offer abemaciclib+ET / if low grade would offer ET alone
• No adjuvant therapy
• Other