The current state in the adjuvant treatment of the primary breast cancer


Klin Onkol 1993; 6(5): 125-128.

We can conclude that on the basis of present state of knowledge almost all breast cancer patients with clinical and pathologic stage I and II regardless of age, menopausal, nodal or receptor status, will benefit from some type of adjuvant chemotherapy and/or hormonal therapy in terms of improved disease-free, as well as overall survival. The 1992 St. Gallen treatment recommendations confirm and expand on the guidelines suggested four years ago in St. Gallen. There are two important milestones in the development of adjuvant treatment strategies for breast cancer: the late effects of ovarian ablation and early benefit from primary chemotherapy. Approaches which include their combination represent a valid treatment option for future trials aimed to further improve treatment outcome in women with this disease. Author analyses the problems of overprolonged TMX administration and role of anthra-cyclines in adjuvant chemotherapy of breast cancer. Although further clinical investigation is imperative, it is no incumbent upon each physician to apply the known adjuvant therapeutic regimens broadly, so as not to deny any patient the specific benefits of adjuvant therapy that already have been demonstrated. Author stress the importance of meta-analysis in the evaluation of similar controlled randomized clinical trials.