Improvement in survival after recurrence of carcinoma of the breast

The survival experience of 187 patients who developed recurrent breast carcinoma during the years 1961-1968 was compared to a similar series of 70 cases whose recurrences developed between 1975 and 1978. 'Modern' combination chemotherapy was available for the treatment of the later series of patients only. Survival from the time of recurrence was significantly longer in the more recently treated patients (median 22.8 vs 13.3 months, P = 0.002). The difference persisted when factors known to influence survival after recurrence were taken into account and did not appear to be due to earlier diagnosis of recurrence. These results, which suggest an impact of chemotherapy upon survival, are consistent with a few other studies, but contrast with recent reports from randomized trials that combination chemotherapy fails to prolong life. Possible explanations for these discordant findings are suggested.