Systemic Adjuvant Therapy for Node-Negative Breast Cancer: Proven or Premature?
Authors: Kathleen I. Pritchard
Journal: Annals of Internal Medicine (1989)

Editorials1 July 1989Systemic Adjuvant Therapy for Node-Negative Breast Cancer: Proven or Premature?Kathleen I. Pritchard, MDKathleen I. Pritchard, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-111-1-1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptUntil recently, it has not been considered standard practice to administer adjuvant systemic therapy after surgery to any group of women with node-negative breast cancer (1). These women have relatively few relapses, only 25% to 28% at 10 years, compared with a 10-year relapse rate of 75% in women with node-positive disease (2, 3). Overall survival rates, similarly, are 65% to 82% at 10 years for women with node-negative disease and 25% to 40% for women with involved axillary nodes (2, 3). Recurrence and survival rates for node-negative women are, however, still far from ideal.Before 1988, only a few...References1. Consensus C. Adjuvant chemotherapy for breast cancer. JAMA. 1985;254:3461-3. CrossrefMedlineGoogle Scholar2. FisherSlackKatrychWolmark BNDN. Ten year follow-up results of patients with carcinoma of the breast in a co-operative clinical trial evaluating surgical adjuvant chemotherapy. Surg Gynecol Obstet. 1975;140:528-34. MedlineGoogle Scholar3. ValagussaBonadonnaVeronesi PGU. Patterns of relapse and survival following radical mastectomy. Cancer. 1978;41:1170-8. CrossrefMedlineGoogle Scholar4. BonadonnaValagussaZambettiBuzzoniMoliterni GPMRA. Milan adjuvant trials for stage I-II breast cancer. In: Salmon SE, ed. Adjuvant Therapy of Cancer V. New York: Grune & Stratton; 1987:211-21. Google Scholar5. SemiglazovBavliMoiseyenko VJV. Clinical trials on adjuvant chemotherapy for breast cancer. Cancer. 1986;57:1957-60. CrossrefMedlineGoogle Scholar6. JakeszKolbReiner RRG. Adjuvant chemotherapy in node negative breast cancer patients. In: Salmon SE, ed. Adjuvant Therapy of Cancer V. New York: Grune & Stratton; 1987:223-31. Google Scholar7. Senn H, Barett-Mahler R for the OSAKO and SAKK Groups. Update of Swiss adjuvant trials with LMF and CMF in operable breast cancer. In: Salmon SE, ed. Adjuvant Therapy of Cancer V. New York: Grune & Stratton; 1987:243-52. Google Scholar8. WilliamsBuchananHall CRV. Adjuvant chemotherapy for T1-2, No, Mo, estrogen receptor negative breast cancer: preliminary results of a randomized trial. In: Salmon SE, ed. Adjuvant Therapy of Cancer V. New York: Grune & Stratton; 1987:233-41. Google Scholar9. MorrisonHowellGrieve JAR. The West Midlands Oncology Association trials of adjuvant chemotherapy for operable breast cancer. In: Salmon SE, ed. Adjuvant Therapy of Cancer V. New York: Grune & Stratton; 1987:311-8. Google Scholar10. Nissen-MeyerHostKjellgrenManssonNorin RHKBT. Neo-adjuvant chemotherapy in breast cancer: as single perioperative treatment and with supplementary long-term chemotherapy. In: Salmon SE, ed. Adjuvant Therapy of Cancer V. New York: Grune & Stratton; 1987:253-61. Google Scholar11. Controlled trial of tamoxifen as a single adjuvant agent in the management of early breast cancer. Nolvadex Adjuvant Trial Organisation. Br J Cancer. 1988;57:608-11. CrossrefMedlineGoogle Scholar12. Adjuvant tamoxifen in the management of operable breast cancer: the Scottish Trial. Report from the Breast Cancer Trials Committee, Scottish Cancer Trials Office (MRC), Edinburgh. Lancet. 1987;2:171-5. MedlineGoogle Scholar13. Cyclophosphamide and tamoxifen as adjuvant therapies in the management of breast cancer. CRC Adjuvant Breast Trial Working Party. Br J Cancer. 1988;57:604-7. CrossrefMedlineGoogle Scholar14. . Clinical Alert, Bethesda, Maryland: National Cancer Institute; May 16-18, 1988. Google Scholar15. FisherRedmondDimitrov BCN. A randomized clinical trial evaluating sequential methotrexate and fluorouracil in the treatment of patients with node-negative breast cancer who have estrogen-receptor-negative tumors. N Engl J Med. 1989;320:473-8. CrossrefMedlineGoogle Scholar16. MansourGrayShatila ERA. Efficacy of adjuvant chemotherapy in high-risk node-negative breast cancer. An intergroup study. N Engl J Med. 1989;320:485-90. CrossrefMedlineGoogle Scholar17. Prolonged disease-free survival after one course of peri-operative adjuvant chemotherapy for node-negative breast cancer. The Ludwig Breast Cancer Study Group. N Engl J Med. 1989;320:491-6. CrossrefMedlineGoogle Scholar18. FisherCostantinoRedmond BJC. A randomized clinical trial evaluating tamoxifen in the treatment of patients with node-negative breast cancer who have estrogen-receptor-positive tumors. N Engl J Med. 1989;320:479-84. CrossrefMedlineGoogle Scholar19. Effects of adjuvant tamoxifen and of cytotoxic therapy on mortality in early breast cancer: an overview of 61 randomized trials among 28, 896 women. Early Breast Cancer Trialists' Collaborative Group. N Engl J Med. 1988;319:1681-92. CrossrefMedlineGoogle Scholar20. DeVita V. Breast cancer therapy: exercising all our options [Editorial]. N Engl J Med. 1989;320:527-9. CrossrefMedlineGoogle Scholar21. Glick J. Meeting highlights: adjuvant therapy for breast cancer. J Natl Cancer Inst. 1988;80:471-5. CrossrefMedlineGoogle Scholar22. McGuire W. Adjuvant therapy of node-negative breast cancer: another point of view [Letter]. J Natl Cancer Inst. 1988;80:1075-6. CrossrefMedlineGoogle Scholar23. McGuireAbeloffFisherGlickHendersonOsborne WMBJIC. Adjuvant therapy in node negative breast cancer. In: Oncology Viewpoints. New York: LP Communications; 1988. American Society of Clinical Oncology Special Issue. Google Scholar24. Jordan V. Role of tamoxifen in the long-term treatment and prevention of breast cancer. Oncology. 1988;2:19-24. MedlineGoogle Scholar25. SawkaPritchardPaterson CKA. Role and mechanism of action of tamoxifen in premenopausal women with metastatic breast cancer. Cancer Res. 1986;46:3152-6. MedlineGoogle Scholar26. GotfredsenChristiansenPalshof ACT. The effect of tamoxifen on bone mineral content in premenopausal women with breast cancer. Cancer. 1984;53:853-7. CrossrefMedlineGoogle Scholar27. LoveMazessTormeyBardenNewcombJordan RRDHPV. Bone mineral density in women with breast cancer treated with tamoxifen for at least two years. Breast Cancer Res Treat. 1988;12:297-301. CrossrefMedlineGoogle Scholar28. BruningBonfrerHart PJA. Tamoxifen, serum lipoproteins and cardiovascular risk. Br J Cancer. 1988;58:497-9. CrossrefMedlineGoogle Scholar29. RossnerWallgren SA. Serum lipoproteins after breast cancer surgery and effects of tamoxifen. Atherosclerosis. 1984;52:339-46. CrossrefMedlineGoogle Scholar30. BertelliPronzatoAmoroso GPD. Adjuvant tamoxifen in primary breast cancer: influence on plasma lipids and antithrombin III levels. Breast Cancer Res Treat. 1988;12:307-10. CrossrefMedlineGoogle Scholar31. KillackeyHakesPierce MTV. Endometrial adenocarcinoma in breast cancer patients receiving antiestrogens. Cancer Treat Rep. 1985;69:237-8. MedlineGoogle Scholar32. FornanderRutqvistCedermark TLB. Adjuvant tamoxifen in early breast cancer: occurrence of new primary cancers. Lancet. 1989;1:117-20. CrossrefMedlineGoogle Scholar33. TormeyJordan DV. Long-term tamoxifen adjuvant therapy in node-positive breast cancer: a metabolic and pilot clinical study. Breast Cancer Res Treat. 1984;4:297-302. CrossrefMedlineGoogle Scholar34. MaguireTaitBrooke GAM. Psychiatric morbidity and physical toxicity associated with adjuvant chemotherapy after mastectomy. Br Med J. 1980;281:1179-80. CrossrefMedlineGoogle Scholar35. HoldenerNissen-MeyerBonadonna ERG. Second malignant neoplasms in operable carcinoma of the breast. Recent Results Cancer Res. 1984;96:188-96. CrossrefMedlineGoogle Scholar36. CoatesGebskiBishop AVJ. Improving the quality of life during chemotherapy for advanced breast cancer. A comparison of intermittent and continuous treatment strategies. N Engl J Med. 1987;317:1490-5. CrossrefMedlineGoogle Scholar37. GoldhirschGelberSimesGlasziouCoates ARRPA. Costs and benefits of adjuvant therapy in breast cancer: a quality-adjusted survival analysis. J Clin Oncol. 1989;7:36-44. CrossrefMedlineGoogle Scholar38. FisherCarboneEconomou BPS. 1-phenylalanine mustard (L-PAM) in the management of primary breast cancer. N Engl J Med. 1975;292:117-22. CrossrefMedlineGoogle Scholar39. BonadonnaBrusamolinoValagussa GEP. Combination chemotherapy as an adjuvant treatment in operable breast cancer. N Engl J Med. 1976;294:405-10. CrossrefMedlineGoogle Scholar40. Henderson I. Primary treatment of breast cancer. In: Harris JR, Hellman S, Henderson IC, Kinne DW, eds. Breast Diseases. Philadelphia: JB Lippincott; 1987:350. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Sunnybrook Medical Centre University of Toronto Toronto, Ontario Nextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byBreast DiseasesLong-term survival of T1 and T2 lymph node-negative breast cancer patients according to mitotic activity index: A population-based studyProliferative activity in primary breast carcinomas is a salient prognostic factorAn Outcome Study of Breast Reconstruction: Presurgical Identification of Risk Factors for ComplicationsFlow cytometry in primary breast carcinomas. 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