Adjuvant therapy for breast cancer: who should get what?

• Adjuvant tamoxifen citrate benefits all women who have hormone-sensitive breast cancer.• Adjuvant chemotherapy benefits all women who have breast cancer, but the proportional benefits are greater in women younger than 50 years.• The proportional reduction in recurrence and mortality as a result of adjuvant treatment is the same for each patient, but the absolute benefits depend On a patient's risk.• Women with smaller-than-1 cm, node-negative, estrogen receptor-positive breast cancer of low histologic grade have an excellent prognosis without further therapy.• Treatment decisions should be individualized, taking into consideration the clinical evidence and a patient's overall health treatment preferences.