Effect of chemotherapy on survival in metastatic breast cancer.

In order to assess the impact of modern combination chemotherapy on overall survival of metastatic breast cancer patients, we retrospectively analysed survival data of those patients who presented with breast cancer and developed metastases at our clinic from 1971-78 inclusive. Our results indicate a trend towards improved survival from onset of first distant metastasis after 1975. Assessment of survival by treatment modality revealed significantly longer survival from first metastasis for those patients receiving predominantly endocrine treatment compared to chemotherapy, median survival being 32.5 versus 23 months for endocrine therapy and chemotherapy respectively. Patients receiving adriamycin in combination with other drugs, had longer survival from first metastasis than those patients receiving chemotherapy without adriamycin (median survival being 25 versus 18.5 months respectively). These differences are most probably due to patient selection. On the basis of these results it would appear that chemotherapy may be improving short-term survival in some patients, but is making no major impact on long-term survival.