In which scenarios would you consider adjuvant CDK4/6 inhibitor use if there is only one ipsilateral axillary lymph node positive for microscopic disease?

For patients with stage II hormone receptor-positive, HER2-negative breast cancer that is grade 3, I would offer adjuvant ribociclib irrespective of whether they are node-positive or node-negative because such patients would be included in the NATALEE trial, and both groups had statistically significant improvements in IDFS with 3 years of adjuvant ribociclib compared to placebo. This patient has micrometastatic disease in the axillary lymph node, and by convention, this would be considered node...