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July 8, 1988

Clinical Alert Gives Breast Cancer Data, Revises Recommendations

JAMA. 1988;260(2):153-154. doi:10.1001/jama.1988.03410020013002

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THE NATIONAL CANCER Institute (NCI) is still getting responses to a clinical alert it mailed out six weeks ago.

In the now-familiar missive, dispatched to 13 000 physicians who treat patients with breast cancer, NCI Director Vincent T. DeVita, Jr, MD, urged consideration of adjuvant chemotherapy, hormonal therapy, or both after primary treatment for invasive earlystage breast cancer that has not spread to the lymph nodes. He did so on the basis of early results from three multicenter trials, which indicated that these adjuvant therapies improved diseasefree survival rates in women with this type of breast cancer.

Because the data presented in the alert are still somewhat sketchy, physician response has been mixed, according to NCI officials. Some, who want to start patients on chemotherapy immediately, have received further information on treatment programs from the institute's Physician Data Query computer database. Others say they prefer to wait until they have