Do all breast cancer patients need chemotherapy?

Do all breast cancer patients need chemotherapy?

Whether chemotherapy is needed after breast cancer surgery depends on the patient's pathological type. Breast cancer can be roughly divided into two types: carcinoma in situ and invasive carcinoma. Carcinoma in situ generally does not metastasize, so chemotherapy is usually not required. Most invasive carcinomas require chemotherapy.

1. Breast carcinoma in situ: The cancer cells of breast carcinoma in situ are limited to the mammary ducts and have not spread to the surrounding tissues or the axillary lymph nodes. Therefore, chemotherapy is generally not required, and clinical cure can usually be achieved by surgical resection alone.

2. Invasive cancer: Only a small number of cases are special cases that do not require chemotherapy. For example, for Luminal A breast cancer, if Ki-67 is less than 15%, the tumor size is less than 2 cm, the histological grade is grade one or two, there is no metastasis to the axillary lymph nodes, and the age is over 35 years old, then chemotherapy is not required. For other types of breast cancer, as long as there is no metastasis to the axillary lymph nodes and the tumor size is less than 0.5 cm, chemotherapy is not required.