Selection of young women with high-risk breast cancer for adjuvant systemic therapy

Biological criteria of tumour aggressiveness have recently been recommended for use in selecting high-risk cases for adjuvant systemic therapy after primary treatment of breast cancer. Without them, the clinician has considerable difficulty in balancing the morbidity of cytotoxic therapy against the possible benefits. Consistent evidence that patients under the age of 35 years have the worst prognosis of all age groups, while those in the 45-49 age group have the best prognosis, should help in a decision on suitable adjuvant treatment for either node-positive or node-negative young women with breast cancer.