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Moretti E et al. – With current evidence, neither HER–2 status nor topoisomerase IIalpha status can be considered clinically valuable in guiding prescription of anthracyclines. Disease heterogeneity may dictate prediction by tumour profiles, rather than any single marker. These profiles may incorporate a panel of markers, including not only tumour features, such as HER–2 and topoisomerase IIalpha, but also host–determined features, such as stroma and stroma–anthracycline interaction. A new generation of well powered clinical trials that attempt to incorporate breast cancer heterogeneity may bridge the gap between available results and individual patient care.

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