In addition, some authors have stated that women younger than 50 years, with smaller tumours (T1/T2), a lower volume of metastatic disease and those without HER-2/neu amplification and fewer comorbidities are more likely to be treated with aggressive multimodal therapy in the form of surgical excision of the primary tumour and local radiotherapy and systemic treatment [9, 11, 31, 32, 36]. This evidence concerns the gene ERBB2 and neoplasm.