We review controversial issues taken from the vast literature on adjuvant treatment of early breast cancer. We conclude that the role of tamoxifen in premenopausal women is still controversial and that ovariectomy in this patient population cannot be routinely recommended outside clinical trials. The current literature certainly supports the use of anthracyclines in adjuvant chemotherapy regimens, but we feel that high dose chemotherapy with peripheral blood stem cell support should still be restricted to randomized clinical trials. Finally, we would like to emphasize that the current standard of adjuvant treatment of early breast cancer are prospectively randomized clinical trials which provide a stronghold of good patient care and will allow to tackle and answer important controversial issues regarding this frequent cancer.