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The integration of adjuvant chemotherapy and endocrine therapy was thought to be settled several years ago with the publication of Southwest Oncology Group (SWOG) study 8814 (Proc Am Soc Clin Oncol 2002; 21:abstr 143). In that study, premenopausal patients with early stage, axillary node–positive breast cancer were randomized to chemotherapy (cyclophosphamide, doxorubicin, and 5-fluorouracil) plus concurrent tamoxifen, chemotherapy followed by tamoxifen, or tamoxifen alone. Patients who received sequential, rather than concurrent, chemotherapy and endocrine therapy achieved superior disease-free survival (DFS); thus, these results were practice changing, and international guidelines reflected the apparent advantage of sequential adjuvant ch…