Adjunctive chemotherapy as an alternative to ovarian ablation in premenopausal women with carcinoma of the breast.
The beneficial effects observed from adjunctive chemotherapy in premenopausal women with carcinoma of the breast may be due only to ovarian ablation. Beneficial effects of chemotherapy induced amenorrhea was noted in four of five reported adjunctive trials. Chemotherapy appears to delay recurrence but has only minimal effect on survival rates. The results of four of five studies comparing ovarian ablation with controls show a consistent, but modest, prolongation of disease-free survival rates from oophorectomy similar to that observed from adjunctive chemotherapy. The benefits are accomplished with less morbidity from ovarian ablation. Additional trials are needed to prove whether or not chemotherapy is more beneficial than adjunctive ovarian ablation in delaying recurrence and if either prolong survival time. Such trials should compare intensive adjunctive chemotherapy with either minimal or no adjunctive therapies. Therapy to be given at the time of recurrence should be defined at the outset to assure comparable over-all treatment among groups.
Wolberg
W H
WH
Department of Surgery, University of Wisconsin-Madison 53792.
D000328:Adult; D000568:Amenorrhea / Q000139:chemically induced; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D002277:Carcinoma / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008593:Menopause; D008598:Menstruation; D008875:Middle Aged; D010052:Ovariectomy
D000970:Antineoplastic Agents