Whether or not to give adjuvant chemotherapy for breast cancer.

There is no longer any reasonable doubt that adjuvant chemotherapy prolongs survival for premenopausal women with early breast cancer. Indeed, in more than 100 years of research into breast cancer management it is the first form of treatment convincingly shown to have survival benefit. Yet important questions linger over its real clinical value. These include the balance of benefit against morbidity, and the possibility that the treatment effect may be largely endocrine-mediated. For many clinicians whether or not to give adjuvant chemotherapy is still a difficult decision.