Chemotherapy of advanced breast cancer. A general survey

Most patients with locally advanced primary breast cancer and almost all patients with disseminated malignancy will ultimately die of their disease. Nevertheless, because breast cancer is one of the most responsive of the solid tumors to cytotoxic drugs, appropriately chosen chemotherapy can relieve symptoms and prolong survival. Adriamycin (doxorubicin) is the most effective among many useful single agents. Combination chemotherapy can augment responses with acceptable toxicity and, along with hormonal manipulation in selected situations, constitutes the standard of care for metastatic disease in 1983. In the interpretation of the clinical oncology literature, meticulous attention to prognostic factors and details of study design is necessary in order to assess the superiority of any particular regimen. Controlled clinical trials of various drug combinations and schedules are especially valuable. The use of an integrated clinical approach involving rational surgical, radiologic, and medical strategies in the management of locally advanced as well as metastatic breast cancer can provide not only meaningful palliation but prolonged disease-free survival for many patients with this common neoplasm.