Adjuvant therapy of breast cancer 1971-1981. Ten years of progress.

Adjuvant therapy in the past 10 years has gone from experimental to clinical practice for women who are premenopausal. For the postmenopausal and the elderly patient the treatment for some is still experimental and for others proven. Obviously, we need to collect data for all patients because we do not have information on 10 or 20 year survivals, the long-term effects of chemotherapy, or the role of adjuvant hormonal therapy. Likewise further trials are needed to define the optimal duration of treatment, the role of adriamycin combinations, and the utility of chemotherapy in node negative patients. Future trials will undoubtedly include lesser surgery options. The hope of the future lies in the definition of more specific options for treatment, avoiding the unnecessary toxicity of radical surgery, extensive X-ray therapy or needless chemotherapy. These answers will come from well-designed clinical trials, well-integrated with good laboratory studies designed to explore biological as well as mechanistic questions.