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- • Earlier combinations that have been tried include melphalan + 5-FU for premenopausal women and melphalan
- + 5FU + tamoxifen for postmenopausal women with receptor positive tumors. Recent studies suggest that
- shorter courses of cyclophosphamide + doxorubicin (AC) may be at least as good as CMF given for six
- months.
- • Doxorubicin can produce cardiac toxicity, a form of heart muscle weakness. This can be disabling and
- life-threatening, but the risk can be reduced by giving the drug slowly via continuous intravenous infusion over
- one or more days and by limiting the total dosage.
- • A related drug, mitoxantrone , appears to be nearly as effective and is associated with less cardiac toxicity.
- • Adjuvant chemotherapy has been shown to prolong the disease-free interval and survival of Stage II
- premenopausal patients with positive axillary lymph nodes . The treatment lasts four to six months in most
- programs.
- • There may be some benefit in giving adjuvant chemotherapy to postmenopausal women with positive axillary
- nodes, but the results are less impressive than in premenopausal patients.
-