How would you treat a T2N1 ER 90%, PR 10%, HER-2 negative breast cancer in premenopausal women with a tumor abutting the pectoralis fascia with loss of fat plane, with a concern for a positive surgical margin?

I would strongly consider neoadjuvant chemotherapy to improve resectability, assess treatment response, and reduce the risk of positive margins and extensive axillary surgery. Given the tumor’s proximity to the pectoralis fascia with loss of the fat plane, there is a real concern that upfront surger...