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October 1988

Adjuvant Therapy for Node-Negative Breast Cancer PatientsWho Benefits?

Arch Surg. 1988;123(10):1189-1190. doi:10.1001/archsurg.1988.01400340015001

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On May 16, 1988, the National Cancer Institute issued a "Clinical Alert" that has generated considerable publicity regarding three clinical trials involving node-negative breast cancer patients who received either adjuvant chemotherapy or hormonal therapy vs observation only. These randomized prospective trials, conducted by the National Surgical Adjuvant Breast Project and the Intergroup Study (Eastern Cooperative Oncology Group, Southwest Oncology Group, and Cancer and Leukemia Group B), represent an important step in extending the use of systemic therapy to yet another subset of breast cancer patients.

Unfortunately, the incomplete dissemination of information about these trials and the exaggerated interpretations of the results by the lay press and others have led to considerable confusion about specifically which node-negative breast cancer patients should receive postoperative chemotherapy or hormonal therapy as "standard treatment." For example, the New York Times (May 21, 1988) published a front-page article under the headline "Cancer Drug Therapy Urged for

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