Systemic chemotherapy as an adjuvant to surgery in the treatment of breast cancer

T therapeutic agent systemically in conjunction with radical mastectomy to decrease the recurrence rate and enhance survival of patients with breast cancer is an appealing one. It might be anticipated that such a therapeutic regimen could destroy cells dislodged into the blood and lymph during surgical manipulation and,/or destroy minute metastatic foci of tumor which defy detection. To verify the value of such a therapeutic effort, a series of clinical trials involving the cooperative efforts of 45 institutions (Addendum) was begun i n 1957 and became known as the National Surgical Adjuvant Breast Project. As a result of publicity accorded these studies at their onset-before their worth or danger was remotely established-adjuvant chemotherapy was widely employed by many i n the treatment of breast cancer. Only recently have definitive results of this project become known. While detailed findings have been published elsewhere,lv 2 this report will clarify the present status of such therapy in the treatment of breast cancer.