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Adjuvant chemotherapy for HER2-negative breast cancer

Harold Burstein, MD, PhD
Section Editor
Daniel F Hayes, MD
Deputy Editor
Sadhna R Vora, MD


Breast cancer is a global health problem and the most common cancer in both resource-rich and resource-poor settings. The lifetime probability of developing breast cancer is one in six overall (one in eight for invasive disease). It is a heterogeneous, phenotypically diverse disease composed of several biologic subtypes that have distinct behaviors and responses to therapy.

The use of adjuvant systemic therapy is responsible for much of the reduction in cause-specific mortality from breast cancer seen in almost every Western nation [1]. Adjuvant chemotherapy refers to the use of cytotoxic chemotherapy after breast cancer surgery, administered with the goal of eradicating microscopic foci of cancer cells that, if untreated, could grow and recur as metastatic cancer. In general, similar chemotherapy regimens are used as adjuvant chemotherapy regardless as to whether tumors are estrogen (ER) or progesterone (PR) receptor positive or negative. Treatment directed against the human epidermal growth factor receptor 2 (HER2) is incorporated for those patients with HER2 overexpression. (See "Adjuvant systemic therapy for HER2-positive breast cancer".)

This topic will discuss the role of chemotherapy in the adjuvant treatment of early-stage breast cancer, how to estimate the benefit and risk of chemotherapy, the indications for adjuvant chemotherapy, and the dosing and timing of treatment. Adjuvant medical therapy for patients with early-stage HER2-positive breast cancer, adjuvant endocrine therapy, the treatment of male breast cancer, and breast cancer in older patients are discussed separately:

(See "Adjuvant systemic therapy for HER2-positive breast cancer".)

(See "Adjuvant endocrine therapy for non-metastatic, hormone receptor-positive breast cancer".)


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Literature review current through: Jun 2016. | This topic last updated: Jun 30, 2016.
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