Management Recommendations for Adjuvant Systemic Breast Cancer Therapy

Abstract

It is estimated that over 211,000 women in the United States will be diagnosed with breast cancer in the year 2003 [1]. Despite the modest decreases in the ageadjusted mortality rate for breast cancer that have occurred since the 1980’s, methods to further improve these rates are needed. Appropriate local therapy remains the cornerstone of treatment for patients with non-metastatic breast cancer. Methods to achieve this goal include earlier diagnosis, better general medical care, and appropriate administration of systemic adjuvant treatments following resection of breast cancer. A large amount of data have been accumulated over the last few years, helping us to better understand the utilization of ovarian ablation, hormonal therapy, and chemotherapy, as well as local treatments for patients with early breast cancer. Some of these data were discussed as part of the Early Breast Cancer Trialists’ Group (EBCTG) conferences in 1998 and 2000 [2,3], the 2000 National Institutes of Health (NIH) Consensus Conference [4], and the St. Gallen meetings from 2001 and 2003 [5]. Several important trials evaluating ovarian ablation, aromatase inhibitors, taxanes, and schedule of chemotherapy are relevant to clinical practice. Sys-