Adjuvant treatment for breast cancer

Adjuvant treatment for breast cancer is given following primary surgical management and aims to reduce the risk of recurrence (both local and distant) as well as improve survival rates. Radiotherapy is delivered to reduce local recurrence risk. Whole breast radiotherapy is considered standard treatment following breast-conserving surgery for invasive cancer and is also considered after mastectomy depending on pathological risk factors. Systemic therapies (such as chemotherapy, endocrine treatment and biological therapy) reduce the risk of distant metastases and improve overall survival. The decision to advise adjuvant treatment is complex (taking into account both prognostic and patient factors) and is made with the patient following a multidisciplinary team meeting. It is now common practice to employ benefit–risk calculators in the clinical setting to aid treatment decision making. Recent major advances in both systemic treatments and radiotherapy techniques have led to more personalized treatment for patients with the aim to reduce breast cancer mortality even further.