In general, chemotherapy improves recurrence-free and overall survival in patients with early breast cancer, but the possible benefits should be weighted against toxicities and the socio-economic burden for the individual patient. The benefits appear to be less in patients with hormone receptor positive tumours aged 59 or older and endocrine therapy alone might be preferred in these patients. A regimen containing anthracyclines and taxanes, the most active drugs in primary breast cancer, is preferable if chemotherapy is to be used, e.g. epirubicin and cyclophosphamide followed by docetaxel.