Biomaterial Database

Current status and indications for adjuvant therapy in breast cancer. 1982

H J Senn

1. Modified radical mastectomy is the standard surgical procedure today in most countries. 'Lesser surgery' associated with radiotherapy emerges as an alternative for patients with T1N0 lesions. 2. The potential risk of occult micrometastases is best predicted by careful axillary staging and possibly by the ER status of the primary tumor. 3. Additional risk factors such as tumor size, patients age, menopausal status, and intramammary lymphatic or vascular invasion are less well established and need clarification. 4. Previous studies showed no significant long-term benefit of adjuvant radiotherapy and at best a marginal increase of lifespan by adjuvant castration in patients subjected to radical surgery. 5. Various types of adequately intensive adjuvant chemotherapy resulted in a significant increase of relapse-free survival and probably also overall survival 5-6 years after mastectomy in pre- and possibly also postmenopausal N+ patients. 6. Treatment intensity (full doses) of adjuvant chemotherapy seems to be more critical than treatment duration (CMF X 6 is as good as CMF X 12). 7. Adjuvant chemotherapy with drug combinations is generally more effective than single drugs. No combination so far (if adequate doses are given) is clearly superior. 8. Whether early peri-operative onset of adjuvant chemotherapy or combinations with endocrine measures or cyclic, alternating drug regimens increase effectiveness remains to be shown. 9. Adjuvant chemotherapy in N- patients, though still experimental, appears rewarding. 10. The pattern of first relapse has not been significantly altered by the use of adjuvant chemotherapy. Response rate and duration with secondary treatments are consistent with common experience in metastatic disease. 11. Up to 5-6 years median observation time there is no proof that the risk of second neoplasms is increased by currently used adjuvant chemotherapy regimens. 12. More and highly critical prospective trials are needed to assess not only effectiveness, but also patient tolerance (cost-benefit ratio) of adjuvant therapies in breast cancer.

UI	MeSH Term	Description	Entries
D009364	Neoplasm Recurrence, Local	The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site.	Local Neoplasm Recurrence,Local Neoplasm Recurrences,Locoregional Neoplasm Recurrence,Neoplasm Recurrence, Locoregional,Neoplasm Recurrences, Local,Recurrence, Local Neoplasm,Recurrence, Locoregional Neoplasm,Recurrences, Local Neoplasm,Locoregional Neoplasm Recurrences,Neoplasm Recurrences, Locoregional,Recurrences, Locoregional Neoplasm
D001943	Breast Neoplasms	Tumors or cancer of the human BREAST.	Breast Cancer,Breast Tumors,Cancer of Breast,Breast Carcinoma,Cancer of the Breast,Human Mammary Carcinoma,Malignant Neoplasm of Breast,Malignant Tumor of Breast,Mammary Cancer,Mammary Carcinoma, Human,Mammary Neoplasm, Human,Mammary Neoplasms, Human,Neoplasms, Breast,Tumors, Breast,Breast Carcinomas,Breast Malignant Neoplasm,Breast Malignant Neoplasms,Breast Malignant Tumor,Breast Malignant Tumors,Breast Neoplasm,Breast Tumor,Cancer, Breast,Cancer, Mammary,Cancers, Mammary,Carcinoma, Breast,Carcinoma, Human Mammary,Carcinomas, Breast,Carcinomas, Human Mammary,Human Mammary Carcinomas,Human Mammary Neoplasm,Human Mammary Neoplasms,Mammary Cancers,Mammary Carcinomas, Human,Neoplasm, Breast,Neoplasm, Human Mammary,Neoplasms, Human Mammary,Tumor, Breast
D004305	Dose-Response Relationship, Drug	The relationship between the dose of an administered drug and the response of the organism to the drug.	Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D005260	Female		Females
D006728	Hormones	Chemical substances having a specific regulatory effect on the activity of a certain organ or organs. The term was originally applied to substances secreted by various ENDOCRINE GLANDS and transported in the bloodstream to the target organs. It is sometimes extended to include those substances that are not produced by the endocrine glands but that have similar effects.	Hormone,Hormone Receptor Agonists,Agonists, Hormone Receptor,Receptor Agonists, Hormone
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000970	Antineoplastic Agents	Substances that inhibit or prevent the proliferation of NEOPLASMS.	Anticancer Agent,Antineoplastic,Antineoplastic Agent,Antineoplastic Drug,Antitumor Agent,Antitumor Drug,Cancer Chemotherapy Agent,Cancer Chemotherapy Drug,Anticancer Agents,Antineoplastic Drugs,Antineoplastics,Antitumor Agents,Antitumor Drugs,Cancer Chemotherapy Agents,Cancer Chemotherapy Drugs,Chemotherapeutic Anticancer Agents,Chemotherapeutic Anticancer Drug,Agent, Anticancer,Agent, Antineoplastic,Agent, Antitumor,Agent, Cancer Chemotherapy,Agents, Anticancer,Agents, Antineoplastic,Agents, Antitumor,Agents, Cancer Chemotherapy,Agents, Chemotherapeutic Anticancer,Chemotherapy Agent, Cancer,Chemotherapy Agents, Cancer,Chemotherapy Drug, Cancer,Chemotherapy Drugs, Cancer,Drug, Antineoplastic,Drug, Antitumor,Drug, Cancer Chemotherapy,Drug, Chemotherapeutic Anticancer,Drugs, Antineoplastic,Drugs, Antitumor,Drugs, Cancer Chemotherapy