Summary: Pursuant to a congressional request, GAO assessed the extent to which the use of adjuvant chemotherapy changed the survival rates of premenopausal women with breast cancer which had spread to the lymph nodes.
GAO found that: (1) in 1975, two studies concluded that adjuvant chemotherapy showed promise as an effective cancer treatment; (2) in 1985, medical experts reached a consensus that adjuvant chemotherapy had demonstrated a significant increase in disease-free survival and a significant reduction in mortality in premenopausal women with breast cancer which had spread to the lymph nodes; (3) data from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program indicated that there was no statistically significant increase in the 1975 through 1985 survival rates of patients identified as most likely to benefit from adjuvant chemotherapy; and (4) lack of treatment, inadequate control conditions, difficulty in detecting therapy benefits, and inadequate or inappropriate treatment could account for the lack of detectable improvement in survival rates.
