Surgery and chemotherapy in early breast cancer.

The updated results are reported of a prospective controlled clinical trial employing combined chemotherapy with cyclophosphamide, methotrexate and fluorouracil (CMF) as adjuvant treatment in patients with operable breast cancer and positive homolateral axillary lymph nodes (N+). At 36 months from surgery, actuarial analysis shows that there is a significant difference in the relapse rate in favor of adjuvant chemotherapy (45.7% in the control group vs. 26.3% in the CMF group). Distant recurrences were the most frequent site of treatment failure and occurred particularly in the skeleton. The therapy was fairly well tolerated. Both the influence of adjunctive therapy on overall survival after mastectomy and the incidence of long-term side effects are still unknown.