Бажана системна ад'ювантна терапія раку молочної залози*
Axillary Lymph Node | ER+ and/or PR+ | ER− and PR− |
|---|---|---|
Premenopausal | ||
Negative† | Tamoxifen with or without chemotherapy Trastuzumab if HER2+ (sometimes with pertuzumab) | Chemotherapy Trastuzumab if HER2+ (sometimes with pertuzumab ) |
Positive | Chemotherapy plus tamoxifen Trastuzumab plus pertuzumab if HER2+ | Chemotherapy Trastuzumab plus pertuzumab if HER2+ |
Postmenopausal | ||
Negative† | An aromatase inhibitor or tamoxifen (or raloxifene) with or without chemotherapy Trastuzumab if HER2+ (sometimes with pertuzumab) | Chemotherapy Trastuzumab if HER2+ (sometimes with pertuzumab ) |
Positive | Chemotherapy plus an aromatase inhibitor or tamoxifen (or raloxifene) Trastuzumab plus pertuzumab if HER2+ | Chemotherapy Trastuzumab plus pertuzumab if HER2+ |
* For all protocols involving chemotherapy, enrollment in a clinical trial is often considered. | ||
† Treatment of node-negative tumors also depends on tumor size and grade. | ||
ER = estrogen receptor; HER2 = human epidermal growth factor receptor 2; PR = progesterone receptor. | ||