The ultimate "consumer" of the data presented at conferences on the
primary treatment of operable breast cancer is the patient, and when, as
in this disease, the benefits of therapy are relatively mod- est, the
availability and interpretation of the data from trials be- comes an
issue of primary importance. The effects of present treat- ment are in
fact such that more patients relapse despite therapy than are estimated
to benefit from it. It is, therefore, extremely dif- ficult for the
physician to recommend unequivocally one particular adjuvant treatment
modality for the vast population of women with breast cancer. The
interpretation of results from clinical research-oriented pro- grams is
constantly applied, however, in the treatment of breast cancer patients
outside of clinical trials. From presented or publish- ed data, many
physicians extrapolate indications for the use of a given treatment
regimen for their patients, perceiving it as the "best available
therapy. " It is essential that the "best available therapy" be selected
individually for each patient. However, considering the modest effect of
treatment upon outcome, it is imperative that those who provide the
data - those who are involved in both pa- tient care and clinical
research - make it known that the best cur- rent treatment for the
population of breast cancer patients is avail- able within the framework
of clinical trials. In this way not only present-day patients but also
future ones will derive the greatest benefit.