This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Breast, Subject name: Surgery
A 65-year-old woman undergoes a lumpectomy and sentinel lymph node biopsy and is found to have a 5 mm tubular cancer ER and PR positive and a negative sentinel lymph node. What adjuvant treatment should be recommended? 
Select and explain. 
A. Chemotherapy and radiation, B. Radiation treatment only, C. Hormonal therapy only, D. Radiotherapy and hormonal therapy
D: Radiotherapy and hormonal therapy
Answer: D: Radiotherapy and hormonal therapy 
Explanation: Generally, patients with small (<1 cm) breast cancers, which are pathologically node negative, are spared from chemotherapy. Radiation and hormonal therapy is indicated. Partial breast irradiation can be offered though there is no current randomized data to show the best modality of treatment (currently an ongoing NSABP/RTOG trial).