M.D. Over the years it has been estimated that thousands of women's lives have been saved through the use of proper therapy after breast cancer is diagnosed. Modern treatment means no unnecessary loss of life to the best that technology permits. In the 1980's the National Institute of Health physicians met and determined that women before the age of menopause with breast cancer and lymph node involvement should indeed be recommended to have adjuvant or additional chemotherapy once the cancer had been removed. At that time, it was recommended that post-menopausal woman with lymph nodes containing cancer and estrogen receptors were consistent with hormonal sensitivity should receive Tamoxifen.
Tamoxifen is a hormonal agent used commonly in the treatment of breast cancer.
At that time, the proper treatment for women with lymph node negative breast cancer was less clear but has been modified over the last ten years. In a recent article by Bernard Fisher, an important cancer researcher and published in the Journal of the National Cancer Institute evaluated systemic therapy for women with lymph node negative breast carcinoma. It was known that the use of Tamoxifen was beneficial when it was continued for five years but not longer in lymph node negative estrogen receptor positive women. However, because the authors felt the benefits of Tamoxifen could be improved, subsequent studies were performed to evaluate the addition of chemotherapy to Tamoxifen to determine if greater benefit would be achieved than using Tamoxifen alone in these breast cancer patients with no lymph node involvement and estrogen positivity status. Between 1988 and 1993 patients who randomly allocated to Tamoxifen alone, Tamoxifen plus Methotrexate and Fluorouracil or Tamoxifen plus Cyclophosphamide, Methotrexate and Fluorouracil.