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Adjuvant therapy
Relative Indications for
chemotherapy in addition to
endocrine therapy
Area of uncertainty for
indication to chemotherapy in
addition to endocrine therapy
Relative Indications for
endocrine therapy alone
Histological Grade 3
High or intermediate “genomic
risk”
Histological Grade 2
Intermediate “genomic risk”
Histological Grade 1
Low “genomic risk”
High proliferation
a
Intermediate proliferation
Low proliferation
Lower ER and PgR level
High/Intermediate degree of ER
and PgR expression
Higher ER and PgR level
Node positive (4 or more
involved nodes)
Node positive (1-3 involved
nodes)
Node negative
Presence of extensive
peritumoral vascular invasion
Absence of extensive
peritumoral vascular invasion
pT > 5 cm
pT 2.1 – 5 cm
pT ≤ 2cm