How would you treat a post-menopausal woman found to have a node-negative ipsilateral HR+ breast cancer recurrence with pectoral muscle invasion following a prior mastectomy, radiation, and AI therapy completed > 5 years ago?   

I would probably give "neoadjuvant" therapy... according to the age of the patients, comorbidities, prior exposure to chemo in the past, and biology of the HR+/HER2-, I would choose between neoadjuvant chemotherapy or neoadjuvant endocrine therapy (with or without a CDK 4/6 inhibitor).