Adjuvant chemotherapy in early-stage breast cancer: what, when, and for whom?

Adjuvant chemotherapy is effective in reducing the risk of recurrence and death from breast cancer. Tumor stage and biologic characteristics are important when making decisions about who should receive chemotherapy and what chemotherapy to give. The results of ongoing clinical trials will establish whether more precise determination of prognosis and populations most likely and least likely to benefit from specific therapies can improve the efficacy and reduce the toxicity of systemic treatments. As individual tumors are molecularly characterized and molecularly targeted therapies are clinically validated, "personalized" adjuvant therapy will become a reality in the not too distant future.