title: Commentary on September 1985 NIH Consensus Development Conference on Adjuvant Chemotherapy for Breast Cancer.
abstract: The conservative recommendations of the second (1985) NIH Consensus Development Conference on Adjuvant Chemotherapy for Breast Cancer may result in needless premature deaths. The failure to recommend chemotherapy for high-risk postmenopausal patients is contrary to current practice among American oncologists. A recent Chemotherapy Foundation survey of medical oncologists revealed that 75% employed adjuvant polychemotherapy for high-risk postmenopausal women. Valid statistical data supporting the survival benefit of tamoxifen are derived from both Stage I and Stage II postmenopausal patients. While recommending tamoxifen as treatment of choice for Stage II, the Consensus lost an opportunity to encourage increased survival in Stage I patients and also discouraged chemoprevention trials such as those now underway in England. The curative potential of chemotherapy for high-risk women regardless of age was ignored despite several large studies ongoing now for 8-19 years which indicate 10-27% increased disease-free survival. As many as 10,000-15,000 lives per year could be saved in the United States by more realistic recommendations and the application of early aggressive chemotherapy for high-risk patients and tamoxifen for Stage I postmenopausal patients.
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001290:Attitude; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009316:National Institutes of Health (U.S.); D009367:Neoplasm Staging; D011960:Receptors, Estrogen / Q000032:analysis; D013629:Tamoxifen / Q000008:administration & dosage; D014481:United States
chemical_list: D011960:Receptors, Estrogen; D013629:Tamoxifen