Adjuvant chemotherapy of breast cancer

Because of remarkable early success in trials of adjuvant chemotherapy for breast cancer, the National Institutes of Health recently sponsored a consensus conference to evaluate the data in this field and to examine "the impact of such trials on general medical practice." Clear-cut recommendations emerged after two days of presentations and discussions all right, but several conference attendees thought the consensus document was so general as to limit its usefulness. In the end, the recommendations' primary value may be to alert physicians to consider seriously adjuvant chemotherapy for many of their breast cancer patients and to help define which patients are most likely to receive benefit. In addition, since treatment decisions in this area are not always clear, the panel counseled that "optimal care requires frank and open communication between the physician and patient about the options available." Premenopausal Patients The premenopausal woman with breast cancer that has spread to