Standard of care is to do adjuvant chemotherapy. But we know that ‘biology trumps anatomy’. It is entirely possible that she has chemo-insensitive disease. But there are no trials that has evaluated a strategy of omitting adjuvant chemotherapy with N2/3 disease. I think all of this calls...

The total body of evidence for the 21-gene assay in the setting of 1-3 LNs is supportive of the current NCCN guidelines, which suggest considering that patients with ER+ disease, one to three positive nodes, and low RS can avoid adjuvant chemotherapy and receive endocrine therapy alone, o...

ASCO guidelines no 21 gene assay Adjuvant chemo

If she has no medical contraindication to chemotherapy, yes. And assuming she has no contraindication to treatment with an anthracycline, I would favor an AC-T sequence, in either order (my preference is to give the taxane first, which is usually less toxic and causes less or no stem cell damage tha...