Generally, patients with early-stage breast cancer undergo primary surgery (breast-conserving surgery or mastectomy) with or without radiotherapy. Following local treatment, adjuvant systemic therapy may be recommended based on primary tumor characteristics, such as tumor size, stage, lymph node involvement, ER/PR status, and expression of the HER2 receptor. However, in the pandemic period, some priorities have also changed in the treatment of invasive breast cancer. ER+ early breast cancer patients should have neoadjuvant endocrine therapy before surgery during the COVID-19 pandemic. The decision of selection between Tamoxifen and aromatase inhibitors depends on patients’ premenopausal or postmenopausal situation and hormonal status. If the patient is not postmenopausal, sequential evaluation of hormonal status is recommended to consider an alternative endocrine agent.[12]