Micrometastases in patients with primary breast cancer are the rationale for adjuvant systemic treatment. The Early Breast Cancer Trialists' Collaborative Group (EBCTCG) sequential studies have shown that adjuvant systemic therapy decreases recurrence and prolongs survival. According to tumour and patient-related prognostic factors, the risk for relapse could be evaluated. If the risk for relapse is over 10% for 10 years, adjuvant systemic therapy is indicated. Adjuvant chemotherapy is associated with a greater 15-year absolute reduction in death in premenopausal than in postmenopausal patients. Anthracycline- based regimens have demonstrated superiority over classic cyclophoshamide, methotrexate and 5- fluorouracil (CMF) combination chemotherapy, and the role of taxanes is questionable. Timing and duration of adjuvant chemotherapy plays an important role in its individualization. The need for tailored treatments in premenopausal patients is most pronounced in women under 35 years of age at diagnosis.
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