Table 4 Management of patients with breast cancer without lymph node involvement (N−ve)
Premenopausl woman or ⩽50 years old ( Figure 18 ) | Postmenopausal woman or >50 years old ( Figure 19 ) | |||||
|---|---|---|---|---|---|---|
Risk of metastatic recurrence a | No risk of metastatic recurrence | Risk of metastatic recurrence a | No risk of metastatic recurrence | |||
ER+ve | ER−ve or unknown | ER+ve or unknown | ER−ve | |||
Standards | Chemotherapy and tamoxifen | Chemotherapy no hormonotherapy (level of evidence: B) | No adjuvant treatment | Tamoxifen | No standard | No adjuvant treatment |
Options | Chemotherapy and ovarian suppression, and tamoxifen | Tamoxifen if ER+ve | Tamoxifen and chemotherapy | Chemotherapy | Tamoxifen if ER+ve | |
Ovarian suppression ±tamoxifen (no chemotherapy) | No adjuvant medical treatment | |||||
Recommendations | Combination of tamoxifen and chemotherapy in the setting of randomised clinical trials (level of evidence: B) | |||||
