Choosing between endocrine therapy and chemotherapy--or is there a role for combination therapy?

Results from many randomized trials of adjuvant breast cancer therapy have been presented in several overviews and at subsequent meetings. This manuscript reviews the current status of both chemo- and endocrine therapy and the prospects for combination therapy, as summarized at the NIH and St Gallen Consensus meetings. In conclusion, treatment selection should be based primarily on endocrine responsiveness; however, a collaborative approach involving the development of new agents and investigation of their optimal integration into therapy programs will ensure progress and improved patient care.