The results of randomized trials evaluating the use of early or
adjuvant systemic treatment for patients with resectable breast
cancer provide an eloquent rebuttal to those who would argue that
we have made no progress in the treatment of cancer. Many of the
tumors that we have been most successful in curing with
chemotherapy and other newer forms of treatment are relatively
uncommon. In contrast, breast cancer continues to be the single
most common malignancy among women in the western world, is
increasingly a cause of death throughout Asia and Third-World
countries, and remains one of the most substantial causes of cancer
mortality world wide. The use of mammography as a means of early
detection has been shown to reduce breast cancer mortality by
25-35% among those popu lations in which it is utilized. The use of
adjuvant systemic treatment in appropriate patients provides a
similar (and additional) reduction in breast cancer mortality. Few
subjects have been so systematically studied in the history of
medicine, and it seems fair to conclude that the value to adjuvant
systemic therapy in prolonging the lives of women with breast
cancer is more firmly supported by empirical evidence than even the
more conventional or primary treatments using various combinations
ofsurgery and radiotherapy."
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