How would you treat an elderly patient with borderline cardiac dysfunction who has stage 3 HR+ HER2- breast cancer?

If she has an invasive lobular carcinoma and is a borderline candidate for chemotherapy, can possibly try using neoadjuvant letrazole for 3-6 months with close monitoring with breast MRI every 2 months to make sure there is no progression and assess response. If she is lucky and has CR/PR, then poss...

If she is well enough for chemotherapy (based on performance status, end organ function, functional status) and she would benefit from chemotherapy (using an Oncotype or MammaPrint assays), then I would treat with four cycles of docetaxel and cyclophosphamide every 3 weeks with pegfilgrastim support...