Adjuvant Therapy with Curative Intent: Is That Really So?

It is a mantra, a dogma, a belief system. It has merit. It has saved many lives. It is almost 50 years now since Bernie Fisher first noted the high relapse rate in patients with breast cancer who had been “cured” by surgery. He realized more needed to be done. He set up systemic studies, went step by step and established a new approach to the understanding and “early” breast cancer. Seventy years before that, Halstead had developed what was thought to be the best approach for the treatment of breast cancer. Based on the best thinking and understanding at that time, he developed a surgical method that helped many but also reduced the quality of life of many others without giving them any benefit – that is what we found out later.