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Previous Volume 344:1997-2008 June 28, 2001 Number 26 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Women with primary invasive breast cancer receive both local and systemic treatment. Surgery and radiation therapy are local treatments given to reduce the risk of recurrent cancer in the breast, chest wall, and regional lymph nodes. In some cases, these local treatments may prevent the dissemination of cancer and may reduce mortality from breast cancer. Cytotoxic chemotherapy and hormonal therapy are systemic treatments given after local treatment to reduce systemic recurrences and overall mortality from breast cancer. Recent guidelines from the National Institutes of Health Consensus Conference, the National Comprehensive Cancer Center Network, and other groups recommend adjuvant chemotherapy, tamoxifen, . . . [Full Text of this Article]

Natural History of Breast Cancer

Benefits of Adjuvant Treatment of Breast Cancer

Problems in Studying Treatment-Related Side Effects

Adjuvant Chemotherapy

Myelosuppression

Nausea and Vomiting

Neurologic Toxicity

Weight Gain

Ovarian Failure

Cardiac Toxicity

Second Cancers

Fatigue and Quality of Life

Cognitive Dysfunction

Tamoxifen

Serum Lipids and Cardiovascular Mortality

Coagulation and Thrombosis

Second Cancers

Skeletal Effects

Vaginal and Vasomotor Symptoms, Depression, Weight Gain, and Ocular Toxicity

Radiation Therapy

Cardiac Toxicity

Second Cancers

Pneumonitis

Lymphedema, Brachial Plexopathy, and Rib Fractures

Conclusions

Source Information

From the Department of Hematology and Oncology, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Ohio State University, Columbus, Ohio (C.L.S.); and the Department of Radiation Oncology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston (A.R.).

Address reprint requests to Dr. Shapiro at Ohio State University, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, 320 W. 10th St., Columbus, OH 43210, or at shapiro-1@medctr.osu.edu.

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