IS THE ADJUVANT THERAPY FOR NODE-NEGATIVE BREAST-CANCER NECESSARY

Results from randomized clinical trials for women with breast cancer presenting without axillary lymph node involvement indicate that: (1) the prognosis of the cohorts treated with surgery alone is worse than previously reported, and (2) disease-free survival may be significantly improved by systemic adjuvant therapy. The most important task today in addition to procuring a more effective systemic treatment for this disease is to define those prognostic variables which indicate a lower risk for relapse and thus allow selection of patients who can be cured by local means alone. For all others, treatment within clinical trials must become socially and medically acceptable in order to ascertain the best available adjuvant systemic therapy.