OBJECTIVES: For pts with N+ BC, CT with a taxane is a standard treatment, followed by endocrine therapy as indicated. Letrozole (LET) has shown an overall survival (OS) benefit relative to tamoxifen (TAM) in postmenopausal  women with N+ BC. To assess the relative survival benefits of these interventions, we calculated the NNT to prevent one death. METHODS:  Five-year survival data was taken from a pivotal randomized controlled trial (RCT) for LET (N+ pts from BIG 1-98, TAM arm censored for crossover to LET) and from three RCTs of adjuvant taxane CT regimens (AC-T, FEC-D, and DAC). These studies were selected based on comparable follow up and exclusion/inclusion criteria. NNT was calculated with respect to OS at 5 yrs; outcome is presented as the NNT to save a life. RESULTS:  The NNT for OS for adjuvant LET vs. TAM was 27 based on BIG 1-98 in N+ BC pts; this was comparable to the NNTs for taxane based therapies as shown below.   CONCLUSIONS:  The magnitude of OS benefit seen with LET over TAM in BIG 1-98 is similar to that seen with adjuvant taxane based CT regimens. Taxanes are part of standard management of adjuvant BC. These data support the standard use of LET/AIs as well. The studies BIG 1-981: LET vs. TAM, 27; PACS012: FEC-D vs. FEC, 25; BCIRG 0013: DAC vs. FAC, 17; CALGB 93444: ACàT vs. AC, 34 for Exp vs. Controls, OS NNT.  F=Fluorouracil E=Epirubicin  C=Cyclophosphamide D=Docetaxel  T=Paclitaxel A=Doxorubicin. 1Mouridsen 08  2Roche 06  3Martin 05  4Henderson 03