scholarly journals Systemic Adjuvant Therapy of Node Negative Breast Cancer

1992 ◽  
Vol 2 (2) ◽  
pp. 103-109
Author(s):  
Metin Aran
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Node Negative ◽  
Node Negative Breast Cancer ◽  
Systemic Adjuvant Therapy

Time Trends in Systemic Adjuvant Treatment for Node-Negative Breast Cancer

1999 ◽  
Vol 17 (5) ◽  
pp. 1458-1458 ◽  
Author(s):  
Nicole Hébert-Croteau ◽  
Jacques Brisson ◽  
Jean Latreille ◽  
Gilles Gariépy ◽  
Caty Blanchette ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Adjuvant Therapy ◽  
Adjuvant Treatment ◽  
Minimal Risk ◽  
Node Negative ◽  
Risk Of Recurrence ◽  
Consensus Recommendations ◽  
Node Negative Breast Cancer ◽  
Systemic Adjuvant Therapy

PURPOSE: We conducted a population-based study in Quebec, Canada, to assess longitudinal changes in systemic adjuvant therapy for node-negative breast cancer. MATERIALS AND METHODS: A stratified random sample was selected among women with newly diagnosed node-negative breast cancer in 1988, 1991, and 1993. Information on the patient, her tumor, source of care, and treatment was abstracted from medical charts. Patients were classified as being at minimal, moderate, or high risk of recurrence on the basis of criteria proposed at the 4th International Conference on Adjuvant Therapy of Primary Breast Cancer (St. Gallen, Switzerland, 1992), and systemic adjuvant treatment received was dichotomized as being consistent or not consistent with consensus recommendations. RESULTS: Overall, 1,578 cases of invasive breast carcinoma were reviewed. The proportion of patients who were given hormonal or cytotoxic treatment increased from 51.7% to 73.1% from 1988 to 1993. Virtually all women at minimal risk were treated in 1991 and 1993 according to the consensus statement. The proportions of women so treated were 75.0% and 65.4% in the moderate- and high-risk categories, respectively, in 1991. In 1993, these proportions were 71.4% and 67.0%, respectively. Omission of chemotherapy, especially in high-risk women with estrogen receptor–negative tumors who were 50 to 69 years of age, was the most frequent inconsistency with guidelines. CONCLUSION: Systemic adjuvant therapy for node-negative breast cancer has gained acceptance. Better understanding of the decision-making process, of the perception of the risks and benefits involved, and of the impact of alternative strategies for the dissemination of consensus recommendations are needed to promote the use of chemotherapy in specific categories of women who are at high risk of recurrence.

Systemic Adjuvant Therapy in Women With Resected Node-Negative Breast Cancer

1991 ◽  
Vol 66 (8) ◽  
pp. 805-813 ◽  
Author(s):  
LYNN C. HARTMANN ◽  
ROBERT F. MARSCHKE ◽  
DANIEL J. SCHAID ◽  
JAMES N. INGLE
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Node Negative ◽  
Node Negative Breast Cancer ◽  
Systemic Adjuvant Therapy ◽  
Resected Node

Appropriateness of adjuvant systemic therapy for axillary node-negative breast cancer: a physician opinion survey.

1995 ◽  
Vol 13 (6) ◽  
pp. 1459-1469 ◽  
Author(s):  
C A Sawka ◽  
A M O'Connor ◽  
H A Llewellyn-Thomas ◽  
T To ◽  
S P Pinfold ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Combination Chemotherapy ◽  
Current Knowledge ◽  
Menopausal Status ◽  
Specific Treatment ◽  
Patient Specific ◽  
Node Negative ◽  
Node Negative Breast Cancer ◽  
Clinical Scenarios

PURPOSE To examine variations in physicians' recommendations for systemic adjuvant therapy in the treatment of women with node-negative breast cancer (NNBC) and to determine factors used in making specific recommendations. MATERIALS AND METHODS A questionnaire was sent by mail to all 149 Ontario physicians who actively treated breast cancer in 1993. The questionnaire described 48 clinical scenarios of women with NNBC, which included all possible combinations of the following factors: menopausal status, tumor size, hormone receptor status, histologic and nuclear grade, and lymphatic and/or vascular invasion. Respondents rated the appropriateness of administering tamoxifen, combination chemotherapy, or both tamoxifen and combination chemotherapy on a nine-point scale from extremely inappropriate to extremely appropriate. Respondent agreement and disagreement were tabulated for each scenario, and factors associated with specific treatment ratings were analyzed by logistic regression. RESULTS The response rate was 87%. Agreement for the appropriateness of specific therapies was most evident where clinical trials have demonstrated efficacy, whereas disagreement was observed in scenarios in which support for a specific treatment is not available in the current literature. Relevant tumor- and patient-specific factors were used in decision-making; personal characteristics of the respondents had no statistically significant impact on appropriateness ratings. CONCLUSION The physicians surveyed had good knowledge of NNBC prognostic factors, but had a range of opinion on optimal therapy for many clinical scenarios, which reflects current knowledge of the benefits of adjuvant therapy for NNBC.

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