Adjuvant Therapy of Breast Cancer
I. Craig Henderson
Springer US, Aug 31, 1992 - Medical - 464 pages
The results of randomized trials evaluating the use of early or adjuvant systemic treatment for patients with resectable breast cancer provide an eloquent rebuttal to those who would argue that we have made no progress in the treatment of cancer. Many of the tumors that we have been most successful in curing with chemotherapy and other newer forms of treatment are relatively uncommon. In contrast, breast cancer continues to be the single most common malignancy among women in the western world, is increasingly a cause of death throughout Asia and Third-World countries, and remains one of the most substantial causes of cancer mortality world wide. The use of mammography as a means of early detection has been shown to reduce breast cancer mortality by 25-35% among those popu lations in which it is utilized. The use of adjuvant systemic treatment in appropriate patients provides a similar (and additional) reduction in breast cancer mortality. Few subjects have been so systematically studied in the history of medicine, and it seems fair to conclude that the value to adjuvant systemic therapy in prolonging the lives of women with breast cancer is more firmly supported by empirical evidence than even the more conventional or primary treatments using various combinations ofsurgery and radiotherapy.
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Statistical methods for early breast cancer trials
The nature of the benefit
Adjuvant endocrine therapy of breast cancer
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5-fluorouracil 8niv Adjuvant Breast adjuvant chemotherapy adjuvant systemic therapy adjuvant tamoxifen adjuvant therapy advanced breast cancer analysis axillary lymph nodes axillary nodes benefit breast cancer breast cancer cells breast cancer patients breast carcinoma chemo chemopreventive Clin Oncol clinical trials CMFP CMFVP combination chemotherapy cycles cyclophosphamide cytotoxic disease disease-free survival dose intensity doxorubicin drug early breast cancer endocrine therapy Engl estrogen receptor evaluate Fisher follow-up growth factor hormonal therapy human breast cancer mammary mastectomy metastatic metastatic breast cancer methotrexate Mmc periop monoclonal antibodies negative node-negative node-negative breast cancer node-negative patients node-positive NSABP Oncology oophorectomy ovarian ablation overall survival overview patients receiving patients with node-negative postmenopausal postmenopausal women prednisone premenopausal women primary breast cancer prognostic factors Q-TWiST radiotherapy randomized trials receptor status recurrence regimen relapse response risk salvage significant statistically subgroups subset surgery Table tamoxifen toxicity x 1 yrs