Adjuvant Therapy of Breast Cancer

1. Front Matter

   Pages i-ix

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2. Rationale and Methods for Studying Adjuvant Systemic Therapy

   1. Front Matter

      Pages 1-1

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   2. Evolving concepts in the adjuvant systemic therapy of operable breast cancer

      • Larry Norton

      Pages 3-25

   3. Statistical methods for early breast cancer trials

      • Rebecca Gelman

      Pages 27-53

3. Results of Clinical Studies

   1. Front Matter

      Pages 55-55

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   2. The nature of the benefit

      • I. Craig Henderson

      Pages 57-68

   3. Adjuvant endocrine therapy of breast cancer

      • Maureen E. Trudeau, Kathleen I. Pritchard

      Pages 69-114

   4. Adjuvant chemotherapy of axillary lymph-node-positive breast cancer

      • Nancy E. Davidson, Martin D. Abeloff

      Pages 115-145

   5. The node-negative problem

      • David L. Ahmann

      Pages 147-158

4. Special Problems

   1. Front Matter

      Pages 159-159

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   2. Defining the high-risk breast cancer patient

      • Gary M. Clark, William L. McGuire

      Pages 161-187

   3. Models for weighing benefits and toxicities

      • Richard D. Gelber, Aron Goldhirsch

      Pages 189-206

   4. Financial considerations in the use of adjuvant chemotherapy

      • Rebecca Johnson Irvin, John G. Kuhn

      Pages 207-222

   5. The use of adjuvant therapy in patients treated with conservative surgery and radiotherapy

      • Abram Recht, Daniel F. Hayes, Jay R. Harris

      Pages 223-237

   6. Treating the relapsed patient

      • Rowan T. Chlebowski

      Pages 239-253

5. Future Directions

   1. Front Matter

      Pages 255-255

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   2. Unanswered questions in the adjuvant therapy of breast cancer

      • F. Andrew Dorr, Michael A. Friedman

      Pages 257-278

   3. Neoadjuvant chemotherapy

      • William C. Wood

      Pages 279-291

   4. Altering cell kinetics with endocrine therapy

      • R. Paridaens

      Pages 293-313

   5. Polypeptide growth factors: their potential value in the management of breast cancer patients

      • C. Kent Osborne

      Pages 315-329

The results of randomized trials evaluating the use of early or adjuvant systemic treatment for patients with resectable breast cancer provide an eloquent rebuttal to those who would argue that we have made no progress in the treatment of cancer. Many of the tumors that we have been most successful in curing with chemotherapy and other newer forms of treatment are relatively uncommon. In contrast, breast cancer continues to be the single most common malignancy among women in the western world, is increasingly a cause of death throughout Asia and Third-World countries, and remains one of the most substantial causes of cancer mortality world­ wide. The use of mammography as a means of early detection has been shown to reduce breast cancer mortality by 25-35% among those popu­ lations in which it is utilized. The use of adjuvant systemic treatment in appropriate patients provides a similar (and additional) reduction in breast cancer mortality. Few subjects have been so systematically studied in the history of medicine, and it seems fair to conclude that the value to adjuvant systemic therapy in prolonging the lives of women with breast cancer is more firmly supported by empirical evidence than even the more conventional or primary treatments using various combinations ofsurgery and radiotherapy.

• adjuvant therapy
• cell
• clinical trial
• immunotherapy
• prevention
• radiotherapy
• surgery
• systemic therapy

'Overall, this book is a useful review Volume containing thoughtful and up-to-date information on the optimal use of adjuvant therapy for breast cancer. It will be a valuable addition to the library of the practicing clinical oncologist.' Journal of the Nat. Cancer Inst. 85:10 1993

• University of California, San Francisco, USA

  I. Craig Henderson

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