Heat a skillet over medium-high heat. Add beef, mushrooms, onion, and garlic. Saute until beef is browned and crumbly, 6 to 8 minutes. Add flour; cook and stir until combined, about 2 minutes. Add broth, cream of mushroom soup, Worcestershire sauce, pepper, and salt. Bring to a boil; reduce heat. Simmer, stirring occasionally, until flavors blend, about 15 minutes.
Fill a large pot with lightly salted water and bring to a rolling boil. Stir in egg noodles and return to a boil. Cook noodles uncovered, stirring occasionally, until tender yet firm to the bite, about 6 minutes. Drain.
Combine sour cream and horseradish in a bowl; add to the beef mixture. Stir. Cook until hot, about 5 minutes. Serve over hot cooked egg noodles.
If available, use cream of mushroom soup with roasted garlic.
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