CHEMO AND ANTI-ESTROGEN THERAPY IN BREAST CANCER

符合条件的II期和III期乳腺癌患者， 受体测定在原发癌上进行， 将研究乳房切除术。 我们的目的是观察 乳腺癌患者的辅助化疗和抗雌激素治疗， 通过雌激素受体测定分层：A. 阳性淋巴结患者， 原发性肿瘤为雌激素受体阳性（ER+），将被分类为 到更年期。 合格的绝经前ER+患者将 进行手术卵巢切除术并随机分为两组。 一组将给予他莫昔芬三年;另一组将给予他莫昔芬三年。 给予5种药物化疗（CMFVP）+他莫昔芬1年，随访 在接下来的两年里只服用他莫昔芬 B。 绝经后II期 雌激素受体阳性（ER+）的患者将被随机分组 （a）三年的他莫昔芬单药治疗与（B）5种药物化疗之间的差异 （CMFVP）+他莫昔芬治疗1年，随后单独使用他莫昔芬治疗2年 年 C. 雌激素受体阴性（ER-）II期患者， 绝经后，将接受5种药物化疗一年 术后随访，直至出现治疗失败的证据。

Eligible Stage II and III breast cancer patients who have had estrogen receptor assays done on the primary cancer after modified or radical mastectomy will be studied. It is our intent to observe the effect of adjuvant chemotherapy and anti-estrogen therapy in breast cancer patients, stratified by estrogen receptor assay: A. Positive node patients, whose primary tumors are estrogen receptor positive (ER+), will be classified as to their menopausal status. Eligible premenopausal ER+ patients will be subjected to surgical oophorectomy and randomized into one of two groups. One group will be given Tamoxifen for three years; the other group will be given 5-drug chemotherapy (CMFVP) + Tamoxifen for one year to be followed by Tamoxifen alone for the next two years. B. Postmenopausal Stage II patients, who are estrogen receptor positive (ER+), will be randomized between (a) Tamoxifen alone for three years and (b) 5-drug chemotherapy (CMFVP) + Tamoxifen for one year, followed by Tamoxifen alone for two years. C. Estrogen receptor negative (ER-) Stage II patients, both pre and postmenopausal, will be treated with 5-drug chemotherapy for one year postoperatively and followed until evidence of treatment failure occurs.