The 1970s were a decade of change in the treatment of breast cancer. In the management of metastatic disease, hormone receptor assays and two new drugs, tamoxifen and aminoglutethimidine, have caused a reassessment of classical hormonal therapeutic strategies, while combination chemotherapy was found to produce objective antitumor responses and excellent palliation in a majority of patients. In the 1980s clinical investigation of strategies employing mutually non-cross-resistant drug combinations, chemohormonal, or chemoimmunotherapeutic approaches could result in more complete and durable remissions. Immunotherapy and interferon remain investigational approaches of some promise that have yet to find established roles in the treatment of metastatic breast cancer. In the area of adjuvant systemic therapies in primary breast cancer, answers to perplexing questions have begun to emerge. The apparent lack of effectiveness of adjuvant chemotherapy in postmenopausal patients with Stage II breast cancer appears to be a problem of inadequate doses administered to these women in the first two large-scale adjuvant trials. At a follow-up period five years after mastectomy, definite advantage in both overall and relapse free survival are still evident in adjuvant-chemotherapy-treated premenopausal patients compared with patients having radical mastectomy alone. Current trials using more aggressive chemotherapy appear to show equivalent benefit in premenopausal and postmenopausal women. The use of adjuvant radiation therapy before adjuvant chemotherapy appears to be detrimental. Whether newer approaches, such as adjuvant radiation therapy after adjuvant chemotherapy, chemohormonal therapy, or chemoimmunotherapy, are superior to aggressive adjuvant chemotherapy alone remains to be determined through continuing controlled, randomized adjuvant therapeutic trials.
|Original language||English (US)|
|Number of pages||6|
|State||Published - Dec 1 1980|
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