Adjuvant Drug Treatment for Resectable Breast Cancer.

Overview

Breast cancer is the most common life-threatening malignancy in Western women and the second most common cause of cancer-related death. A paradox in the care of patients with breast cancer is the observation that the majority appear to be curable at the time of initial surgery, yet a large number later experience relapse followed by death from disease. To combat this problem, systemic drug therapy in conjunction with surgery and radiation therapy is now standard for many patient subgroups. Standard medical treatment options include up to five years of tamoxifen for receptor positive amenorrheic patients, approximately six months of combination chemotherapy for younger patients and those who are receptor negative, and both in some patient subgroups. These interventions have a profound public health impact even though the majority of patients destined to recur do so even following "optimal" treatment. Further improvements are hoped for as a result of ongoing research involving the use of high-dose chemotherapy, dose-dense chemotherapy, and newer agents. Clinical trials testing these approaches offer the best chance to continue our progress and help to better define appropriate and standard treatment strategies for the future.