Should Future Adjuvant Studies Include Hormonal Manipulations?
Studies of hormonal manipulation as adjuvant therapy for breast cancer have shown suggestive benefits, but are not definitive when judged in terms of survival. Current studies on estrogen receptor status are yielding more reliable data on the value of hormonal manipulation in the adjuvant setting. The problems that exist in the assessment of these current data include determination of the relative roles of hormonal and chemotherapeutic treatments, significance of the hormonal effects of the chemotherapeutic agents and reliability of the receptor assays in individual patients. For now, it appears that no hormonal manipulation has been established with enough confidence to make hormonal alterations–either alone or with chemotherapy–a standard form of adjuvant therapy. Recent data regarding potential benefits for hormonal treatment in patients demonstrating significant estrogen receptor activity are encouraging. ER activity should be quantified routinely in all patients with breast canc
