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The most significant part of breast cancers is the localised stage diagnosis, which are widely curable through a combination of topical and adjuvant systemic treatments. The specific choice of these adjuvant treatments (type, duration and route of administration), as well as the decision whether or not to give them, taking into account the heterogeneity of breast cancer tumours and the improvement in the understanding of the natural history of this disease, plus discussion with the woman, results in increasingly personalised medical treatment. In this article, we are going to review the recent changes, the questions that have arisen and the outlook for adjuvant systemic breast cancer treatments. [ABSTRACT FROM AUTHOR]

HER2-positive breast cancer accounts for 20 to 25% of breast cancers. The surexpression of this tyrosine-kinase receptor is often associated with a poor prognosis. However, the management and the outcome of these patients have changed these last ten years with trastuzumab. Despite the encouraging results obtained with this humanized monoclonal antibody directed against the HER2-receptor, used alone or in association with chemotherapy in metastatic patients, progression under trastuzumab are usually observed and resistances to this treatment are described. Thus, many other monoclonal antibodies and tyrosine-kinase inhibitors emerged. These therapeutics, used alone or in association with chemotherapy or trastuzumab have variable properties: anti-HER2 and anti-EGFR such as lapatinib, pertuzumab and neratinib; anti-EGFR such as erlotinib and gefitinib; antiangiogenesis (bevacizumab, pazopanib); anti-mTOR pathway (temsirolimus, everolimus) or inhibitor of HSP90 (tanespimycine). In this paper, we present an overview on validated targeted therapies and those which are currently under investigation and seem promising in first line or after progression under trastuzumab. Data regarding cardiotoxicity and the use of trastuzumab under particular clinical circumstances (brain metastases, pregnancy) are also reviewed.