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Adjuvant Therapy of Primary Breast Cancer pp 106–112Cite as

Endocrine Effects of Adjuvant Chemotherapy in Premenopausal Women: Suggestions for the Future

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Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 115))

Abstract

Controversy continues to exist concerning the reason for an apparently greater therapeutic effect of postoperative chemotherapy in premenopausal Stage 2 patients as compared with postmenopausal patients (Brincker et al. 1987). The two major reasons suggested for the apparent difference have been a lower dose delivery in postmenopausal patients (Bonadonna and Valagussa 1981) and a drug-induced ovarian ablation in premenopausal patients (Pouquier 1978). The dosing hypothesis is not fully supported by other trials such as that of the Eastern Cooperative Oncology Group (ECOG), wherein the results for postmenopausal patients were similar to those of the initial Milan experience (Tormey et al. 1986). Similary, the differences observed in premenopausal patients with postoperative oophorectomy did not always provide a significant effect or appear to be as great as has been observed with postoperative chemotherapy (Cole 1975; Fisher 1971; Meakin 1986). This chapter examines this controversy further and develops a hypothesis to explain the apparently greater therapeutic impact of chemotherapy among Stage 2 premenopausal patients. The hypothesis suggests a treatment approach which could be tested in future premenopausal adjuvant trials.

Supported in part by the National Cancer Institute, National Institutes of Health, USA, grant #P01-CA20432.

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Authors and Affiliations

  1. Clinical Cancer Center, Department of Human Oncology, K4/632 Clinical Sciences Center, University of Wisconsin, 600 Highland Avenue, Madison, WI, 53792, USA

    D. C. Tormey

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  1. D. C. Tormey
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Editor information

Editors and Affiliations

  1. Medizinische Klinik C, Kantonsspital, 9007, St. Gallen, Switzerland

    Hans-Jörg Senn

  2. Servizio Oncologico Cantonale, Ospedale Civico, 6900, Lugano, Switzerland

    Aron Goldhirsch

  3. Division of Biostatistics and Epidemiology, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA, 02115, USA

    Richard D. Gelber

  4. Abteilung für Hämatologie und Onkologie Medizinische Klinik C, Kantonsspital, 9007, St. Gallen, Switzerland

    Bruno Osterwalder

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© 1989 Springer-Verlag Berlin · Heidelberg

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Tormey, D.C. (1989). Endocrine Effects of Adjuvant Chemotherapy in Premenopausal Women: Suggestions for the Future. In: Senn, HJ., Goldhirsch, A., Gelber, R.D., Osterwalder, B. (eds) Adjuvant Therapy of Primary Breast Cancer. Recent Results in Cancer Research, vol 115. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-83337-3_15

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  • DOI: https://doi.org/10.1007/978-3-642-83337-3_15

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-83339-7

  • Online ISBN: 978-3-642-83337-3

  • eBook Packages: Springer Book Archive

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