Women with primary invasive breast cancer routinely receive surgery and radiation treatment, followed by cytotoxic and hormonal therapy to prevent systemic recurrences and thus increase life expectancy. The benefits from adjuvant chemotherapy are widely recognized; in the US, women with tumors less than 2.0 cm in diameter or 2.0 to 5.0 cm in diameter have a recurrence-free survival chance after 20 years of 74-79% and 63-64%, respectively. Such long-term survivors can be considered as cured. Most of the side effects are reversible; current protocols do not increase mortality or an increase in second cancers. Nevertheless, treatment combinations still have to be optimized and the patients likely to benefit from more individualized therapy need to be identified.
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