Systemic therapy

New data continue to refine our knowledge of systemic therapy for breast cancer. These include the third Oxford Overview on adjuvant systemic therapy, a small advantage of anthracycline regimens over CMF (cyclophosphamide, methotrexate, and 5-fluorouracil), and renewed interest in the 'classic CMF' regimen. Primary chemotherapy offers a greater chance of breast conservation (although no survival advantage), and tamoxifen also benefits women with noninvasive disease. New data are available on biphosphonates, ovarian ablation, anti-estrogens, anti-HER-2 (human epidermal growth factor receptor-2) antibody, and HER-2 expression as a predictive or prognostic factor. Early results of high-dose chemotherapy have been released, and the role of taxanes in early and advanced disease continues to expand. This article reviews these and other recent advances.