EDITORIALS Should Selection of Adjuvant Chemotherapy for Patients With Breast Cancer Be Based on erbB-2 Status?

It has been more than 10 years since the initial report of an association between amplification of erbB-2 (also known as HER-2/neu and ERBB2) and poor clinical outcome of patients with primary breast cancer (1). Dozens of papers involving thou-sands of patients have now been published on this topic, and the general conclusion is that erbB-2 abnormalities, either gene am-plification or protein overexpression, are associated with worse prognosis of patients with lymph node-positive breast cancer, but the relationship for patients with lymph node-negative dis-ease is weak, at best. Since most of these correlative studies were retrospective and many of the patients were treated before ad-juvant therapy was widely administered to patients with lymph node-negative disease, several clinical researchers speculated that these associations were due, in part, to specific adjuvant therapies received by lymph node-positive patients