Prognostic Factors and Treatment Decisions in Axillary-Node-Negative Breast Cancer

Approximately 186,000 new cases of breast cancer will occur in the United States in 1992, and about two thirds of these cases will not involve axillary nodes. This means that each month decisions about adjuvant therapy will be made for more than 10,000 patients with node-negative breast cancer. Why not simply treat all patients with node-negative breast cancer with additional systemic therapy? 1 , 2 One should not, for the following reasons. First, approximately 70 percent of such patients are cured without any adjuvant therapy. Thus, a large number of women without disease would be subjected to the toxic effects of this therapy . . .