Adjuvant Chemotherapy for Small Breast Cancers?

Adding chemotherapy to endocrine therapy did not improve survival for patients with tumors less than 8 mm in size.

Volume of disease, inclusive of tumor size and nodal burden, is one of the primary determinants of risk for recurrence in patients with early-stage breast cancer. For very small-volume disease — such as T1a/b tumors (≤1cm) without nodal involvement — the overall risk for recurrence is relatively low. As such, adding adjuvant chemotherapy to endocrine therapy for small-volume breast cancer is often controversial, particularly for those with small node-negative, HR-positive, ERBB2-positive tumors. Breast cancer guidelines from the National Comprehensive Cancer Network (NCCN; J Natl Compr Canc Netw 2020; 18:45) suggest that for cancers of this type, chemotherapy could be considered if the tumors are >5 mm.

To examine the potential benefit of ad…

Reviewing Author

William J. Gradishar, MD

Disclosures

Consultant/Advisory BoardLilly; AstraZeneca; Gilead

Grant/Research SupportBreast Cancer Research Foundation

Editorial BoardsClinical Breast Cancer; Oncology; Annals of Surgery; Breast Cancer Research and Treatment

Leadership Positions in Professional SocietiesNational Comprehensive Cancer Network (Chair, Breast Cancer Panel); American Board of Internal Medicine (Medical Oncology Board)