Presentation of the Case: A 51-year-old woman presents with an abnormal screening mammogram. Core biopsy shows an invasive ductal cancer that stains strongly for estrogen receptor (ER) and progesterone receptor (PR) and does not overexpress human epidermal growth factor receptor 2. She underwent a partial mastectomy and sentinel node biopsy. The invasive tumor measured 2.1 cm in greatest diameter and was grade 1. There was a 0.4 cm metastatic deposit in one of two sentinel lymph nodes (pT1cN1/stage IIA). There was no tumor within 0.2 cm of all margins and no lymphatic or vascular invasion noted. She was evaluated in the breast multidisciplinary clinic by a medical, surgical, and radiation oncologist. The question for our colleagues is what is the optimal adjuvant therapy for this woman and, more specifically, is chemotherapy necessary?