Interpreting adjuvant breast cancer data in 2006 and beyond

Substantial progress has been made in the multidisciplinary management of early stage breast cancer since the introduction of combination chemotherapy with cyclophosphamide, methotrexate and fluorouracil in the 1970s. Adjuvant chemotherapy significantly reduces the risk of cancer recurrence and death, and these effects persist for up to 20 years post surgery. Numerous attempts have been made to further improve survival outcomes by varying the dose, dose intensity and sequencing of drug delivery. The Cancer and Leukemia Group B (CALGB) conducted a series of trials examining these variations in adjuvant chemotherapy for the treatment of node-positive breast cancer patients. In this report, we discuss the major findings from some of these studies and highlight the role of oestrogen-receptor status on survival outcomes of modern chemotherapy.