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This Article Full Text Full Text (PDF) Supplementary Data All Versions of this Article: ERC-09-0033v1 16/4/1091    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Montemurro, F. Articles by Aglietta, M. PubMed PubMed Citation Articles by Montemurro, F. Articles by Aglietta, M.

Divisione Universitaria di Oncologia Medica ed Ematologia, Istituto per la ricerca e la Cura del Cancro, 10060 Candiolo (Torino), Italy

(Correspondence should be addressed to F Montemurro; Email: filippo.montemurro{at}ircc.it)

Current adjuvant treatments for operable breast cancer include chemotherapy, endocrine therapy in hormone receptor-positive tumors, and trastuzumab for HER2-positive tumors. Metanalyses of randomized trials show that in patients with hormone receptor-positive breast cancer, the effects of endocrine therapy and chemotherapy on survival are non-mutually exclusive. Most of these patients are therefore considered candidates to combined treatment. Recently, however, the endocrine responsiveness of tumors has been redefined on clinical, histopathological, and molecular bases. An emerging concept is that as endocrine responsiveness increases, chemoresponsiveness decreases. In the adjuvant setting, therapeutic choices are often based on small projected improvements in clinical outcomes. As a consequence, the role of chemotherapy and traditional management algorithms in patients with hormone receptor positive is being challenged. This review will address the current controversy regarding the role of adjuvant chemotherapy, including the newer anthracycline and taxane-based programs, in these patients.