Adjuvant chemo- and endocrine therapies are established treatment modalities in primary breast cancer. The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) Overview (1992) has found highly significant reductions in the annual rates of recurrence and death. These reductions were produced by chemotherapy, castration in women below age 50, and by tamoxifen. Tamoxifen appears to be more active in older patients, chemotherapy appears to be more active in younger patients, and ovarian ablation is active in premenopausal women only. At the 1992 International Consensus Conference on risk-adapted adjuvant therapy, treatment recommendations have been made for node-positive and -negative patients. Node-negative patients were divided into minimal-, low-, and high-risk groups. Except for minimal-risk situation, adjuvant systemic treatment was recommended for all women. Treatment decisions are based on menopausal status or age and estrogen receptor status. However, new prognosticators are required. New treatment modalities should reduce the radicality of surgery, radiation and chemotherapy. New concepts of primary (neoadjuvant) use of chemotherapy before a definitive surgical procedure make it possible to avoid mastectomy in nearly all cases. Further reduction of breast cancer mortality can be reached only by chemopreven-tion (e. g. tamoxifen).

Keywords:
Breast cancer, Adjuvant therapy
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© 1993 S. Karger AG, Basel
1993
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