The enormous impact of both clinical and basic research on the
field of breast cancer can now be readily appreciated. It is the
purpose of this new series of books to bring together the recent
major advances in our understanding of the disease. The first
volume is devoted exclusively to treatment. It is written by
scholars who are actually investigating the biological principles
which underlie our current approaches to therapy. For example,
countless articles have appeared proposing some ad vantage for one
surgical approach to primary breast cancer compared with another.
The new message is that these arguments for the superior ity of one
surgical approach over a.nother are valid only in that minority of
patients whose disease is absolutely confined to the primary tumor
site. It is far less important which surgical approach is selected
for the larger group of patients who present with occult distant
metastases. The whole subject of adjuvant therapy is still in its
infancy. We have progressed from single-agent adjuvant chemotherapy
to combined modality regimens consisting of combination
chemotherapy plus im munotherapy, plus radiotherapy, plus endocrine
therapy. It will un doubtedly take many years to sort out the
proper use of these agents.
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