Hope Rugo, MD, FASCO, and Naomi Dempsey, MD, provide a comprehensive analysis of risk stratification in high-risk HR+/HER2- early-stage breast cancer, clinical approaches with high-risk breast cancer, recent trial data with CDK4/6 inhibitors, and strategies for managing toxicities for treatment continuity in the management of HR+/HER2- early-stage breast cancer, offering valuable insights to optimize patient care.