By M. H. N. Tattersall (auth.), Professor Dr. Hans-Jörg Senn, Priv.-Doz. Dr. Aron Goldhirsch, Dr. Richard D. Gelber, Dr. Bruno Osterwalder (eds.)

The final "consumer" of the information awarded at meetings at the basic remedy of operable breast melanoma is the sufferer, and while, as during this affliction, the advantages of treatment are fairly mod­ est, the provision and interpretation of the information from trials be­ comes a subject matter of fundamental significance. the results of current deal with­ ment are actually such that extra sufferers relapse regardless of treatment than are envisioned to profit from it. it really is, accordingly, tremendous dif­ ficult for the health professional to suggest unequivocally one specific adjuvant remedy modality for the massive inhabitants of girls with breast melanoma. the translation of effects from medical research-oriented professional­ grams is consistently utilized, although, within the therapy of breast melanoma sufferers outdoors of scientific trials. From awarded or put up­ ed information, many physicians extrapolate symptoms for using a given remedy routine for his or her sufferers, perceiving it because the "best to be had treatment. " it truly is crucial that the "best to be had remedy" be chosen separately for every sufferer. although, contemplating the modest impression of therapy upon consequence, it really is relevant that those that give you the facts - people who find themselves fascinated about either pa­ tient care and medical learn - make it identified that the simplest cur­ hire remedy for the inhabitants of breast melanoma sufferers is avail­ capable in the framework of scientific trials. during this means not just present-day sufferers but additionally destiny ones will derive the best benefit.

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1988; Merkel et al. 1987; Sampat et al. 1977; Silvestrini et al. 1986; Thorpe et al. 1987; Valagussa et al. 1978, 1984), include negative hormone receptors (Merkel et al. 1987; Thorpe et al. 1987; Valagussa et al. 1984), high tumor grade (Rank et al. 1987; Silvestrini et al. 1986), vascular invasion (Sampat et al. 1977), and assessment of tumor kinetics (Meyer et al. 1983; Silvestrini et al. 1986), etc. Of particular interest are the more recent data from DNA assessment, including flow cytometry determination of S-phase percentage and ploidy (Hedley et al.

Other types of approach, practiced routinely in many European countries, would include a direct referral of newly diagnosed cancer patients to an oncological institute. In all instances, major departures from the present management of breast cancer wilI be required. Only very effective and clearly understood publicity aimed at general surgeons, the general population (patients), and physicians, wilI achieve such a major change. Indications for a clear benefit of the preoperative over the postoperative approach wiII be needed, however, before these alterations will be adopted uniformly.

It also allows the assessment of the activity of a given combination in a given patient by measuring the amount of tumor regression, and it ensures the early management of micrometastases which will ultimately cause the death of the majority of patients. We shall not repeat here the theoretical (Goldie and Coldman 1979), experimental (Karrer et al. 1967; Schabel et al. 1979), and clinical data (Nissen-Meyer et al. 1978; Fisher et al. 1982) in support of neoadjuvant chemotherapy. The local treatment chosen in this study is radiotherapy.

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