How would you approach a postmenopausal woman with Stage I HR+,HER2- breast cancer who had a CVA while on tamoxifen?   

A major co-morbidity such as a stroke should prompt a re evaluation of the benefit risk ratio and overall value of adjuvant endocrine therapy, especially for low risk disease. It would be helpful to unpack this situation a little more. How bad is the stroke and how much loss of mobility and performa...

Switch to Aromatase Inhibitors. A better approach for post-menopausal women regardless. 

Depending on her age and other comorbidities, as well as other characteristics of her disease, she may be able to have observation alone.