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JNCI Journal of the National Cancer Institute 2004 96(24):1801-1804; doi:10.1093/jnci/djh347
© 2004 by Oxford University Press
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© 2004 Oxford University Press

EDITORIAL

Adjuvant Chemotherapy for Lymph Node–Negative, Estrogen Receptor–Negative Breast Cancer: A Tale of Three Trials

Kathy S. Albain

Correspondence to: Kathy S. Albain, MD, Division of Hematology/Oncology, Loyola University Chicago Stritch School of Medicine, Cardinal Bernardin Cancer Center, 2160 S. First Ave., Maywood, IL 60153 (e-mail: kalbain@lumc.edu)

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Mortality from breast cancer continues to decline in North America and other parts of the world (1,2). This improvement was initially attributed to widespread adoption of mammography screening recommendations. However, much of the recent ongoing decline in breast cancer mortality is most likely a result of the increased use of systemic adjuvant chemotherapy and hormonal therapy. The benefit from adjuvant treatment is observed not only in women with axillary lymph node–positive disease but also in women diagnosed with the most common presentation in North America: axillary lymph node–negative breast cancer. For patients with hormone receptor–negative breast cancer, systemic chemotherapy improves the odds of disease-free and overall survival to the same relative degree as it does for patients with lymph node–positive disease, whereas hormonal therapy such as tamoxifen is not helpful for patients with receptor-negative disease. A meta-analysis of worldwide adjuvant clinical trials by the Early . . . [Full Text of this Article]


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