Mechanism of action of adjuvant chemotherapy in early breast cancer

N Padmanabhan, A Howell, R D Rubens

Research output: Contribution to journalArticlepeer-review


The relation between tumour oestrogen and progesterone receptor status, menstrual status, relapse-free survival, and overall survival was analysed in 411 patients with early breast cancer randomised to receive either postoperative adjuvant chemotherapy with cyclophosphamide, methotrexate, and fluorouracil (CMF) or no additional treatment (control). Prolongation of time to recurrence and survival was seen predominantly in premenopausal patients; these effects were seen only with tumours positive for steroid receptors, particularly progesterone. Chemotherapy led to permanent amenorrhoea in 61% of premenopausal patients. The therapeutic effects of chemotherapy were seen only when CMF induced permanent amenorrhoea in premenopausal patients. These findings support the hypothesis that the effect of adjuvant chemotherapy in early breast cancer may be mediated by ovarian suppression.

Original languageEnglish
Pages (from-to)411-414
Number of pages4
JournalLancet (London, England)
Issue number8504
Publication statusPublished - 23 Aug 1986


  • Adult
  • Age Factors
  • Aged
  • Amenorrhea
  • Breast Neoplasms
  • Clinical Trials as Topic
  • Combined Modality Therapy
  • Cyclophosphamide
  • Female
  • Fluorouracil
  • Follow-Up Studies
  • Humans
  • Mastectomy
  • Menopause
  • Methotrexate
  • Middle Aged
  • Postoperative Period
  • Random Allocation
  • Receptors, Estrogen
  • Receptors, Progesterone
  • Time Factors
  • Clinical Trial
  • Comparative Study
  • Journal Article
  • Randomized Controlled Trial


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