Adjuvant Chemotherapy for Breast Cancer — 30 Years Later

In 1976, Bonadonna and his colleagues published the results of their landmark trial of adjuvant chemotherapy for breast cancer.1 They showed that 12 months of postoperative chemotherapy consisting of cyclophosphamide, methotrexate, and fluorouracil (CMF) decreased the risk of recurrence of breast cancer in women with positive axillary lymph nodes. Since then, many trials have been undertaken to answer important questions about adjuvant chemotherapy: What is the optimal number of drugs? What are the most advantageous doses of the agents used for adjuvant chemotherapy? How long should they be administered? Does the inclusion of an anthracycline improve the outcome? In many . . .