Adjuvant Therapy of Primary Breast Cancer

The ultimate "e;consumer"e; of the data presented at conferences on the primary treatment of operable breast cancer is the patient, and when, as in this disease, the benefits of therapy are relatively mod- est, the availability and interpretation of the data from trials be- comes an issue of primary importance. The effects of present treat- ment are in fact such that more patients relapse despite therapy than are estimated to benefit from it. It is, therefore, extremely dif- ficult for the physician to recommend unequivocally one particular adjuvant treatment modality for the vast population of women with breast cancer. The interpretation of results from clinical research-oriented pro- grams is constantly applied, however, in the treatment of breast cancer patients outside of clinical trials. From presented or publish- ed data, many physicians extrapolate indications for the use of a given treatment regimen for their patients, perceiving it as the "e;best available therapy. "e; It is essential that the "e;best available therapy"e; be selected individually for each patient. However, considering the modest effect of treatment upon outcome, it is imperative that those who provide the data - those who are involved in both pa- tient care and clinical research - make it known that the best cur- rent treatment for the population of breast cancer patients is avail- able within the framework of clinical trials. In this way not only present-day patients but also future ones will derive the greatest benefit.