Commentary (Carraway/Wolff): Selecting Adjuvant Endocrine Therapy for Breast Cancer
December 01, 2004
Our understanding of the biologyof breast cancer has undoubtedlyimproved in the pastdecade, and remarkable progress hasbeen achieved in its treatment. Thosecaring for these patients have longrealized that breast cancer is a diseasewith an extremely diverse natural history,and much remains to be learnedabout the interaction among knownpredictive and prognostic factors. Notlong ago, the “more is better” strategyexemplified by high-dose chemotherapy(often resulting in high-dose toxicity)dominated the research agendaand clinical practices of many institutions.Although a minimum chemotherapydose intensity is requiredand increasing the frequency of specificregimens is advantageous, furtherdose intensification with orwithout stem cell rescue[4-6] offersno meaningful benefit in the adjuvantsetting.