Correspondence

Adjuvant Therapy for Early Breast Cancer

N Engl J Med 2007; 356:1268-1269March 22, 2007

Article

To the Editor:

Poole et al. (Nov. 2 issue)1 conclude that patients with breast cancer benefit from the addition of four cycles of epirubicin to cyclophosphamide, methotrexate, and fluorouracil (CMF) in the adjuvant setting. In contrast to previously published data, the dose intensity of CMF did not seem to play a role.

Patients with breast cancer were included in the study irrespective of age, nodal status, or estrogen-receptor status. The degree of aggressiveness of the chemotherapy was not tailored to the risk of recurrence. The role of tamoxifen could not be evaluated because for many patients, neither hormone-receptor status nor tamoxifen scheduling was known. In postmenopausal, hormone-receptor–positive patients with breast cancer, tamoxifen has been the standard of care for years, and the addition of chemotherapy has a small effect, if any, on survival.

Serban-Dan Costa, M.D., Ph.D.
Joachim Bischoff, M.D.
Otto-von-Guericke University, 39108 Magdeburg, Germany
serban-dan.costa@medizin.uni-magdeburg.de

1 References

1. 1

   Poole CJ, Earl HM, Hiller L, et al. Epirubicin and cyclophosphamide, methotrexate, and fluorouracil as adjuvant therapy for early breast cancer. N Engl J Med 2006;355:1851-1862
   Full Text | Web of Science | Medline