ER + higher risk disease

T2 MODERATE RISK G3 And 1-3 nodes OR CHEMOTHERAPY BENEFIT? ENDOCRINE CDK4/6 ELIGIBLE Paper name Paper name >4 nodes NPI 3.4-5.4

OR

NPI 3.4-5.4

Chemotherapy
Benefit?

CDK4/6
eligible

Endocrine

Pre menopausal

<35 yrs

SOFT Trials

TEXT Trials

>35 yrs

Extended
tamoxifen

aTTom Trials

ATLAS Trials

Post menopausal

AI 10 years

+/-
bisphosphonates