Adjuvant Systemic Therapy: The Issues of Timing and Sequence

  • M. Castiglione-Gertsch
  • R. D. Gelber
  • A. Goldhirsch
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 140)


Adjuvant systemic therapy in breast cancer has been widely used during the last three decades and has been shown to reduce relapses and mortality (Early Breast Cancer Trialist’s Collaborative Group 1992). The rationale for its introduction was that adjuvant treatment may kill tumor cells released into the circulation at the time of primary surgery. Subsequent hypotheses ascribe the high risk for systemic relapse to micrometastases already present at the time of breast cancer diagnosis. Although the interval from breast cancer diagnosis to postoperative adjuvant therapy is short compared to the presumed preclinical duration of tumor growth, it appears that early chemotherapy onset may be advantageous in terms of tumor cell kill and that a delay in starting adjuvant treatments may result in increased resistance to cytotoxics (Goldie and Coldman 1979).


Breast Cancer Adjuvant Systemic Therapy Primary Chemotherapy Early Breast Cancer Trialist International Breast Cancer Study Group 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Berlin Heidelberg 1996

Authors and Affiliations

  • M. Castiglione-Gertsch
    • 1
  • R. D. Gelber
    • 2
  • A. Goldhirsch
    • 3
  1. 1.International Breast Cancer Study GroupCoordinating CenterBernSwitzerland
  2. 2.International Breast Cancer Study Group Statistical CenterDana Farber Cancer InstituteBostonUSA
  3. 3.Servizio Oncologico CantonaleOspedale CivicoLuganoSwitzerland

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