One of the most important aspects of comprehensive breast cancer treatment is chemotherapy, which can significantly improve a patient’s 5- and 10-year survival rates.
In general, in situ breast cancer does not require chemotherapy because there are few or no distant metastases to the lymph nodes. In the case of stage III or higher, patients with distant metastases will undoubtedly require chemotherapy. The choice of patients for chemotherapy is mainly focused on early stage breast cancer patients like stage I and II.
The need for chemotherapy in early stage I and II patients is a common concern. In 2000, the National Institutes of Health (NIH) published a consensus that women with tumors younger than 70 years of age need chemotherapy whether they are menopausal or not, whether they are ER positive or not, and whether they over-express HER2. If the patient is still intolerant, endocrine therapy may be an option. Currently, endocrine therapy is also a treatment of choice for patients who are ER and PR positive, HER-2 negative, and physically intolerant to any chemotherapy.