Is there a benefit to chemotherapy in hormone receptor positive, node positive postmenopausal breast cancer?

Yes: There is a defined benefit of chemotherapy plus an aromatase inhibitor compared to an aromatase inhibitor alone, but it is small. The decision to use chemotherapy in this setting is dependent on whether the tumor is her2/neu +, the stage of the tumor, and the age and health of the patient. All decisions regarding adjuvent therapy hinge around the risks vs. Benefits, which is patient-dependent.

Often: There is increasing data based on the oncotype DX test in women with 1-3 positive notes that shows that some women will not get much benefit from chemo and some will get a great deal. It can be useful in cases where a woman is reluctant to take chemo. This is done on tissue that has been already removed. Most oncologists believe that women who have multiple positive nodes should get chemotherapy.