Adjuvant Systemic Therapy

Abstract

More than half of the women rendered disease free after treatment of the primary tumour eventually develop overt metastases. Metastatic breast cancer is an incurable condition and the majority of patients will have to live with symptoms related to the site of the metastases, and will die of complications related to its progression. This reality was the basis for the development of therapies aimed at reducing relapses and, hence, mortality of patients who were clinically disease free as a result of surgery. The basic hypotheses for the use of a systemic treatment are:

• ◻ In those patients who will eventually relapse, microscopic disease is already present at diagnosis.

• ◻ Cytotoxic or endocrine therapies which have proven to be active in advanced disease (leading to tumour shrinkage) should also have an effect upon such a small tumour cell burden.

• ◻ The methods of primary tumour ablation have little effect upon survival.