Adjuvant systemic therapy for operable breast cancer

Adjuvant systemic therapy is now an important and recognized part of the initial management of patients with operable breast cancer. Its value in delaying relapse and prolonging total survival is established for disease of poor prognosis. For premenopausal patients the currently advised treatment is a 6 months course of CMF polychemotherapy and for postmenopausal patients it is daily tamoxifen for 2-5 years. For patients with disease of good prognosis there is a need to evaluate, within randomized trials, the usefulness of newer biological indicators of prognosis to improve selection for and of treatment. Continued monitoring of long-term results for delayed morbidity is also necessary.