Chemotherapy of breast cancer. A general overview

The symptoms of metastatic breast cancer may be effectively palliated with chemotherapeutic agents in most breast cancer patients. In addition, the survival of many of these patients may be prolonged, sometimes dramatically, but none can be cured with available regimens once metastases are established. The introduction of chemotherapy as an adjuvant immediately following mastectomy or radiotherapy may have curative potential. Studies performed at the Instituto Nazionale Tumori in Milan, Italy have now been reported with six years of follow-up; 43% of premenopausal women treated with mastectomy only are disease-free and 62% are alive. In contrast 60% of the premenopausal women treated with both mastectomy and one year of CMF are disease-free (P less than 0.001) and 78% are alive (P = 0.02). The precise role of chemotherapy for postmenopausal women without node metastasis is still controversial. In addition it is not yet clear which drug regimens are best or whether the differences will still be apparent after 20 years of follow-up. Premature acceptance of currently available chemotherapy regimens may ultimately slow down the rate of development of new programs truly capable of curing patients with breast cancer.