In recent years, the balancing act between risk vs benefit for the addition of anthracyclines has led to their usage being reserved for higher risk cancers like estrogen driven cancers (tumors with multiple nodes, higher risk genomic scores including oncotype score over 30 or mammaprint high risk 2), triple negative breast cancer and less commonly for HER2 driven cancers [191] The recent SCARLET trial is currently evaluating potential omission of anthracyclines for neoadjuvant treatment of triple negative breast cancer [192, 195]. Here, ERBB2 is linked to triple-negative breast carcinoma.