To investigate the impact of adherence to international guidelines about adjuvant systemic therapies on survival rates of operable breast cancer patients in daily medical practice, 298 patients who received adjuvant chemotherapy (CMF or anthracycline-based) and/or tamoxifen were evaluated retrospectively. The 3, 5 and 7.5-year Disease Free Survival (DFS) were 77%, 67% and 61% and Overall Survival (OS) were 88%, 78% and 64%, respectively. Node negative patients have statistically better survival rates than node positive ones (p= 0.0002 for DFS, p= 0.0006 for OS). The only significant variable both for DFS and OS was four or more positive nodes. While recognizing the important impact of evidence-based guidelines on survival rates of early breast cancer patients, it might be very important to stress the weakness of standard chemotherapy regimens for women with four or more positive nodes and the necessity of early recognition for the avoidance of high numbers of involved axillary ganglia. [Turk J Cancer 2005;35(3):123- 131]