Overview of the impact of conventional systemic therapies on breast cancer

Survival in women with breast cancer is improving in the western world, in part related to improved surgery, radiotherapy and adjuvant systemic therapy. Aromatase inhibitors are superior to tamoxifen in this clinical situation and several studies indicate that taxane-based chemotherapy is superior to non-taxane-based regimens. Herceptin is active alone in HER-2/neu +ve advanced breast cancer and four clinical trials are testing this agent in the adjuvant situation. It seems likely that herceptin will add to conventional therapies and thus will be the paradigm for the introduction of other biological therapies to improve cure rates.