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Women with primary invasive breast cancer receive both local and systemic treatment. Surgery and radiation therapy are local treatments given to reduce the risk of recurrent cancer in the breast, chest wall, and regional lymph nodes. In some cases, these local treatments may prevent the dissemination of cancer and may reduce mortality from breast cancer. Cytotoxic chemotherapy and hormonal therapy are systemic treatments given after local treatment to reduce systemic recurrences and overall mortality from breast cancer. Recent guidelines from the National Institutes of Health Consensus Conference, the National Comprehensive Cancer Center Network, and other groups recommend adjuvant chemotherapy, tamoxifen, . . .
Shapiro et al. (Thu,) studied this question.