Adjuvant systemic therapy: state of the art, 1989.

After more than 100 reported randomized trials of systemic adjuvant therapy in breast cancer, it is clear that this therapy will prolong the time to recurrence and the survival time significantly, at least in some patient subsets. But there is less than complete agreement as to which subsets, which therapies, how much benefit can be achieved, and when (if ever) the risk/benefit ratio may not favor this approach. The results of these trials, and some trials still in progress, are summarized, and the current understanding of the role of systemic adjuvant therapy for breast cancer is reviewed.