[Fundamental advances in the adjuvant systemic therapy of breast cancer].

In the last few decades, the notion of breast cancer has developed from a local disease rather to a systemic illness. Today radical operations can mostly be avoided by breast-conserving techniques and sentinel lymph node dissection. By the use of cytostatic and endocrine systemic therapies, an essential gain in overall survival could be obtained, too. High-risk situations can be determined and dealt with accordingly by adequate systemic therapies. Current approaches include the sequential or simultaneous use of anthracyclines and taxanes, the combination with antimetabolites, antibodies and tyrosine kinase inhibitors as well as dose-dense chemotherapeutic regimens. In the adjuvant treatment of breast cancer of postmenopausal receptor-positive patients, tamoxifen is not the gold standard anymore. An aromatase inhibitor should be used at any rate.