No Treatment Standards?

There are extensive, very detailed and well documented treatment guidelines which are used by most cancer specialists.

NCCN Guidelines for Patients® by Cancer Type - Breast Cancer   - the patient version 

NCCN Clinical Practice Guidelines in Oncology - Breast Cancer    - the physician version, much more detailed, but you have to register to be able to access the documents.

These guidelines are updated annually to incorporate new research findings and new treatment protocols. 

Of course each case needs to be assessed individually and there will always be grey areas, situations where it's recommended that a treatment "should be discussed" with the patient, and then together the patient and doctor decide whether to proceed.  Separate from the medical guidelines detailed in these documents, an individual's personal concerns about the risks of the disease and/or the side effects of the treatments, as well as an individual's age and overall health are some of the other factors that play into treatment decisions. 

Take a look at page 72 of the Patient's version.  That's the page that covers the treatment recommendations for your diagnosis.

vbishop

It's important to remember there's no blanket standard of treatment. Everyone is different based on their particular tumor, history, and to an extent, choices. There is NCCN protocol the onco's follow but sometimes the results, like that of the oncotype test which is done on your tumor, falls in the gray area and then it is left to the choice the onco and patient make. Some choose chemo for extra protection because they feel better about it, when others choose not to do chemo when the test results fall in that gray area. The same thing with hormone therapy for ER+, PR+ patients. Some, such as myself, start out on it but can't tolerate the entire 5 years so we have to stop, which is not recommended, but our bodies won't tolerate it. I know it's confusing, and we always wonder if we are making the right treatment decisions, but there's a point we have to trust our onco's direction for us concerning treatment. Just make sure that your onco follows NCCN protocol so his decisions are based on current treatment guidelines, not the guidelines in place when he graduated med school.