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Annals of Oncology 10:S129-S137, 1999
© 1999 European Society for Medical Oncology

Reviews

Adjuvant therapy of breast cancer: Update

T. Cufer

Institute of Oncology of Ljubljana Ljubljana, Slovenia

Correspondence to: Tanja Cufer, MD, PhD Assist. Professor, Medical Director, Institute of Oncology of Ljubljana, Zaloska 2 1000 Ljubljana, Slovenia e-mail: tcufer{at}onko-i.si

The theoretical prediction that breast cancer is a systemic disease, ans that patients may benefit from addition of systemic therapy to local treatment, has now been confirmed by three decades of clinical investigations. A long-term follow up of individual trials and the International Overview based on meta-analyses clearly showed the potential of both hormonal therapies and chemotherapy to prolong disease-free and overall survival in nearly all groups of patients. The benifits have been demonstrated for both premenopausal and postmenopausal patients, with both node-negative and node-positive disease. However, there is still considerable uncertainty regarding the most appropriate treatment for each individual patient. In the present review, the results of meta-analysis are highlighted in the context of the new trials supporting the value of chemoendocrine therapy and anthracycline-based therapy. The results of prospective randomised trials evaluating the role of dose intensification, drug sequencing and dose density are discussed. Also presented are new treatment strategies, such as preoperative chemotherapy and high-dose chemotherapy with stem cell support, the value of which remains to be confirmed. Future possibilities opened by inclusion of biologies into adjuvant therapy are discussed.

adjuvant treatment, breast cancer, systemic therapy


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