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Systemic Adjuvant Therapy for Node-Negative Breast Cancer: Proven or Premature?

Kathleen I. Pritchard, MD
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Requests for Reprints: Kathleen I. Pritchard, MD, Toronto-Bayview Regional Cancer Center, 2075 Bayview Avenue, Toronto, Ontario, Canada 4MN 3M5.

Sunnybrook Medical Centre and
University of Toronto
Toronto, Ontario

Ann Intern Med. 1989;111(1):1-4. doi:10.7326/0003-4819-111-1-1
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Until recently, it has not been considered standard practice to administer adjuvant systemic therapy after surgery to any group of women with node-negative breast cancer (1). These women have relatively few relapses, only 25% to 28% at 10 years, compared with a 10-year relapse rate of 75% in women with node-positive disease (2, 3). Overall survival rates, similarly, are 65% to 82% at 10 years for women with node-negative disease and 25% to 40% for women with involved axillary nodes (2, 3). Recurrence and survival rates for node-negative women are, however, still far from ideal.

Before 1988, only a few


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