[High-risk situation - which is the best chemotherapy?].

High-risk situations in early breast cancer concern patients with less than 3 involved lymph nodes but additional risk factors as well as patients with more than 3 involved lymph nodes. For the first group, new risk assessment methods to better identify the need for chemotherapy with or without a taxane or with a taxane instead of an anthracycline are needed. For the second group, further improvement of anthracycline- or taxane-containing chemotherapy regimens is warranted. Current approaches include the sequential or simultaneous use of these groups of agents, the combination with antimetabolites, antibodies or small molecules, the neoadjuvant use of chemotherapy as well as dose-dense and dose-escalated chemotherapy regimens.