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Adjuvant therapy of node-negative breast cancer
P D Hall1, B A Lesher, R K Hall
1College of Pharmacy, Medical University of South Carolina, Charleston 29425, USA.
The Annals of Pharmacotherapy
|March 1, 1995
Summary
Adjuvant chemotherapy or hormonal therapy may reduce recurrence in node-negative breast cancer. Identifying high-risk patients is crucial to guide treatment decisions and avoid unnecessary toxicity.
Area of Science:
- Oncology
- Breast Cancer Research
Background:
- Node-negative breast cancer treatment remains controversial.
- Many patients (60-80%) survive 10 years without adjuvant therapy.
- Adjuvant therapy use increased after the 1988 National Cancer Institute Clinical Alert.
Purpose of the Study:
- To review controversies in adjuvant cytotoxic chemotherapy or hormonal therapy for node-negative breast cancer.
- To evaluate prognostic factors for identifying patients who benefit from adjuvant therapy.
Main Methods:
- MEDLINE search for primary literature and review articles.
- Inclusion of recent clinical trials and review articles on adjuvant therapy and prognostic factors.
- Evaluation of prognostic factors such as tumor size, hormonal receptors, ploidy, S-phase fraction, and cathepsin D.
Main Results:
- Approximately 60-80% of node-negative breast cancer patients survive 10 years without adjuvant therapy.
- Research focuses on prognostic factors to identify subgroups benefiting from treatment.
- Chemotherapy or hormonal therapy has shown reduced recurrence in some node-negative patients.
Conclusions:
- Local therapy alone cures many node-negative breast cancer patients.
- Up to 58% of node-negative patients may experience recurrence.
- Prioritizing identification of high-risk patients for adjuvant therapy is essential to maximize benefits and minimize harm.