The research team found that laser treatment may be a good treatment option for early stage breast cancer in the future. Krag D, et al. 2003;21:1431–9. Patients will be assigned to different baskets according to tumor type and gene fusion. Adenoid cystic carcinoma (closed to accrual 02 / 06 / 2018) 35. Chordoma (closed to accrual 11 / 29 / 2018) 31. This randomized phase III trial studies whether weight loss in overweight and obese women may prevent breast cancer from coming back (recurrence). Investigators will test new tableted preparation, V3-MOMMO, obtained from hydrolyzed, inactivated blood and tumor tissues of patients with breast cancer. Intensive dose-dense compared with high-dose adjuvant chemotherapy for high-risk operable breast cancer: Southwest Oncology Group/Intergroup Study 9623. … All trials on the list are supported by NCI. Three studies are included that lessened the burden of surgery including the NSABP B-04, NSABP B-06, and NSABP B-32 trials. Location: 26 locations, This is a multicenter Phase 1b, open-label study to assess safety, tolerability, preliminary efficacy, and pharmacokinetics (PK) of cabozantinib taken in combination with atezolizumab in subjects with multiple tumor types, including advanced urothelial carcinoma (UC) (including bladder, renal pelvis, ureter, urethra), renal cell carcinoma (RCC), castration-resistant prostate cancer (CRPC), non-small-cell lung cancer (NSCLC), triple negative breast cancer (TNBC), ovarian cancer (OC), endometrial cancer (EC), hepatocellular cancer (HCC), gastric cancer / gastroesophageal junction cancer / lower esophageal cancer (GC / GEJC / LEC), colorectal cancer (CRC), head and neck (H&N) cancer, and differentiated thyroid cancer (DTC). The Breast Cancer Locator study is a prospective, 1:1 randomized, controlled pivotal trial that will enroll 448 women with non-palpable invasive breast cancer or ductal carcinoma in situ (DCIS) … Clinical trials … Location: 848 locations, This trial studies how well paclitaxel, trastuzumab, and pertuzumab work in eliminating further chemotherapy after surgery in patients with HER2-positive stage II-IIIa breast cancer who have no cancer remaining at surgery (either in the breast or underarm lymph nodes) after pre-operative chemotherapy and HER2-targeted therapy. Chemotherapy drugs, such as cisplatin, carboplatin, and capecitabine, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Location: 30 locations, This phase II trial studies the how well trastuzumab, vinorelbine tartrate, and avelumab with or without utomilumab work in treating patients with HER2-positive breast cancer that has spread to other parts of the body (metastatic). Location: 23 locations, This is an open-label, multicenter, global Phase 2 basket study of entrectinib (RXDX-101) for the treatment of patients with solid tumors that harbor an NTRK1 / 2 / 3, ROS1, or ALK gene fusion. Pheochromocytoma, malignant (closed to accrual) 25. Placebo in Combination With Ado-trastuzumab Emtansine (T-DM1) for Patients With Advanced or Metastatic HER2+ Breast Cancer, Basket Study of Entrectinib (RXDX-101) for the Treatment of Patients With Solid Tumors Harboring NTRK 1 / 2 / 3 (Trk A / B / C), ROS1, or ALK Gene Rearrangements (Fusions), I-SPY TRIAL: Neoadjuvant and Personalized Adaptive Novel Agents to Treat Breast Cancer, A Study of XmAb®20717 in Subjects With Selected Advanced Solid Tumors, Fulvestrant or Exemestane with or without Ribociclib in Patients with Recurrent, Unresectable, or Metastatic Hormone Receptor Positive, HER2 Negative Breast Cancer, Capecitabine in Treating Patients with Metastatic Breast Cancer or Advanced / Metastatic Gastrointestinal Cancers, U.S. Department of Health and Human Services. While doctors are still unclear on what causes breast cancer, research has allowed them to get a … About this trial Everyone in this trial had a single area of breast cancer … Women with ER positive breast cancer normally will receive endocrine therapy and some may receive chemotherapy to help prevent the cancer from coming back. This service is more advanced with JavaScript available, Landmark Trials in Oncology The vaccine was developed by researchers at the Cleveland Clinic in Ohio and works by training the … Transitional cell carcinoma other than that of the renal, pelvis, ureter, or bladder (closed to accrual) 16. We searched PubMed and oncology congress websites (American Society of Clinical Oncology, San Antonio Breast Cancer Symposium, European Society of Medical Oncology) between Jan 1, 2000, and Sept 1, 2015, to identify clinical trials of CDK4/6 inhibitors in combination with adjuvant endocrine therapy for patients with oestrogen-receptor-positive, HER2-negative early breast cancer… Drugs used in chemotherapy, such as paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Many women will also receive radiotherapy to the whole breast / chest area and the surrounding lymph glands (called regional radiotherapy). Location: 1083 locations, This randomized phase III trial studies lymph node dissection and radiation therapy to see how well it works compared to radiation therapy alone in treating patients with breast cancer previously treated with chemotherapy and surgery. Lumpectomy and radiation therapy for the treatment of intraductal breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-17. 2007;25:1677–82. The current trial hypothesizes that "Post-mastectomy radiation in high risk, node negative early breast cancer patients decreases rates of loco-regional recurrence and improves disease free … Study participants … For 2 years, Tyler participated in the trial that used a drug that had previously been used for stage 4 breast cancer patients. Trastuzumab is a form of “targeted therapy” because it works by attaching itself to specific molecules (receptors) on the surface of tumor cells, known as HER2 receptors. For endocrine management, the NSABP B-14, NSABP B-20, NSABP B-24, NSABP P-01, and a meta-analysis by the Early Breast Cancer Trialists’ Collaborative Group are included. There are hundreds of trials to choose from, and therefore, no claim toward completeness can be made in the current format. Brief Summary: This Phase II will evaluate a new type of breast cancer … NSABP-B04: Twenty-five year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation. The Breast Cancer Locator study is a prospective, 1:1 randomized, controlled pivotal trial that will enroll 448 women with non-palpable invasive breast cancer or ductal carcinoma in situ (DCIS) … Research has looked at whether drugs could prevent breast cancer in women with an increased risk of the disease. Location: 20 locations, This is a Phase 1, multiple dose, ascending dose escalation study to define a MTD / RD and regimen of XmAb20717, to describe safety and tolerability, to assess PK and immunogenicity, and to preliminarily assess anti-tumor activity of XmAb20717 in subjects with selected advanced solid tumors. Study will last 3 months, 20 … Malignant giant cell tumors 30. 2014;15:1303–10. Tumor of unknown primary (Cancer of Unknown Primary; CuP) (closed to accrual 12 / 22 / 2017) 33. Clinical trials look at new ways to prevent, detect, or treat disease. Non-epithelial tumors of the ovary: A) Germ cell tumor of ovary B) Mullerian mixed tumor and adenosarcoma (closed to accrual 03 / 30 / 2018) 14. Use of molecular tools to identify patients with indolent breast cancers with ultralow risk over 2 decades. One exploratory single-agent atezolizumab (SAA) cohort may also be enrolled with CRPC subjects. Cite as. Gastrointestinal stromal tumor (GIST) (closed to accrual 09 / 26 / 2018) 38. Location: 33 locations, This randomized pilot phase II trial studies how well fulvestrant with or without palbociclib and avelumab works in treating patients with hormone receptor positive, HER2 negative breast cancer that has spread to other parts of the body or that has come back after a period of improvement and cannot be removed by surgery, and have been previously treated with CDK and endocrine therapy. Study Identifier: NSABP B-59. (closed to accrual) 23. The National Institute for Health and Clinical Excellence (NICE) provide guidance for women at higher risk of breast cancer. A 15-year meta-analysis conducted by the Early Breast Cancer Trialists’ Collaborative Group of long-term outcomes among 100,000 women treated in 123 randomized trials to evaluate polychemotherapy demonstrated a 10-year breast cancer … High-grade neuroendocrine carcinoma (pancreatic neuroendocrine tumor [PNET] should be enrolled in Cohort 22; prostatic neuroendocrine carcinomas should be enrolled into Cohort 52). Cleveland Clinic researchers are getting ready to embark on a clinical trial testing a breast cancer vaccine. 2017;389:1195–205. Adjuvant chemotherapy substantially reduces the risk of breast cancer recurrences and death in early-stage breast cancer. At the moment they recommend that women at high or moderate risk of breast cance… Extrahepatic cholangiocarcinoma and bile duct tumors (closed to accrual 03 / 20 / 2018) 11. N Engl J Med. For anti-HER2 management, five studies are discussed including the NSABP B-31, NCCTG N9831, HERA, CLEOPATRA, and APHINITY trials. Sentinel lymph node resection compared with conventional axillary lymph node dissection in clinically node negative patients with breast cancer: overall survival findings from the NSABP B-32 randomized phase 3 trial. Adjuvant pertuzumab and trastuzumab in early HER2-positive breast cancer. Fibromixoma and low grade mucinous adenocarcinoma (pseudomixoma peritonei) of the appendix and ovary (closed to accrual 03 / 20 / 2018) 8. Clinical trials test the safety and benefits of new treatments as well as new combinations (or new doses) of standard treatments. For 2 years, Tyler participated in the trial that used a drug that had previously been used for stage 4 breast cancer patients. Swain S et al. Trials measured cancer severity in terms of clinical stage (0 to IV), 23, 24, 68, 69 number of involved lymph nodes (0, 1 to 3, or ≥4), 18, 20, 25, 26, 70 and tumor size (mm), 19, 21, 26 and these varied across trials. Lymph node dissection may remove cancer cells that have spread to nearby lymph nodes in patients with breast cancer. 2017;377:122–31. Patients will get T-DM1 injections from the study site staff on the first day of every cycle. Vulvar cancer (temporarily closed to accrual) 36. Treatment of lymph node negative, oestrogen-receptor positive breast cancer: long term findings from National Surgical Adjuvant Breast and Bowel Project randomized clinical trials. Location: 29 locations, The primary objective of this study is to demonstrate that the combination of palbociclib with anti-HER2 therapy plus endocrine therapy is superior to anti-HER2-based therapy plus endocrine therapy alone in improving the outcomes of subjects with hormone receptor-positive, HER2+ metastatic breast cancer. Location: 147 locations, This randomized phase III trial studies proton beam radiation therapy (proton therapy) compared to photon beam radiation therapy (photon therapy) in treating patients with breast cancer that has not spread to other places in the body (non-metastatic). The Southwest Oncology Group/Intergroup Study 9623 demonstrated that there was no survival advantage to using stem cell transplant over more standard chemotherapy and is included. This trial; Search. These trials relate to the multidisciplinary management of breast cancer from the perspective of a radiation oncologist. The National Institute for Health and Clinical Excellence (NICE) provide guidance for women at higher risk of breast cancer. Esserman L, et al. This material is provided for educational purposes only and with the goal of encouraging further study about the landmark trials that have impacted oncology. Olaparib is an inhibitor of PARP, an enzyme that helps repair deoxyribonucleic acid (DNA) when it becomes damaged. Due to the nature of this study design, some tumor cohorts may complete enrollment earlier than others. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomized, multicenter, open label, phase 3 non-inferiority trial. Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer. Three studies are included that lessened the burden of surgery including the NSABP B-04, NSABP B-06, and NSABP B-32 trials. The BRCA-P study will investigate if using Denosumab is a safe and effective way of preventing breast cancer. Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information. Radiation therapy uses high-energy x rays or protons to kill tumor cells. Study Title: Clinical Trial of Neoadjuvant Chemotherapy With Atezolizumab or Placebo in Patients With Triple-Negative Breast Cancer Followed After Surgery by Atezolizumab or Placebo Study Summary… Adenocarcinoma with variants of GU system (excluding prostate cancer) (closed to accrual 07 / 27 / 2018) 21. J Clin Oncol. Peritoneal mesothelioma (temporarily closed to accrual 05 / 08 / 2020) 41. Olaparib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Clear cell ovarian cancer (closed to accrual) 46. N Engl J Med. Radiation therapy uses high energy x-rays to kill tumor cells and shrink tumors. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). Giving fulvestrant with or without palbociclib and avelumab may work better in treating patients with breast cancer. Proton therapy is a type of radiation therapy that uses multiple beams of protons (tiny particles with a positive charge) to kill tumor cells. NCI’s basic information about clinical trials explains the types and phases of trials and how they are carried out. Blocking PARP may help keep cancer cells from repairing their damaged DNA, causing them to die. Neoadjuvant versus adjuvant systemic treatment in breast cancer: a meta-analysis. 2010;28:5132–9. The FDA has approved a triple-negative breast cancer vaccine for use in human clinical trials. The current trial hypothesizes that "Post-mastectomy radiation in high risk, node negative early breast cancer patients decreases rates of loco-regional recurrence and improves disease free … Pertuzumab is a monoclonal antibody that may interfere with the ability of tumor cells to grow and spread. that evaluated a MammaPrint risk stratification system are included as representative of how molecular and genetic innovations promise to transform cancer management. US - Breast Cancer Clinical Trials … Adenocarcinoma with variants of small intestine (closed to accrual 05 / 10 / 2018) 6. Pancreatic neuroendocrine tumor (PNET) (formerly named: Endocrine carcinoma of pancreas and digestive tract.) Utolimumab is a monoclonal antibody that may interfere with the ability of tumor cells to grow and spread. Cameron D, et al. Drugs used in chemotherapy, such as doxorubicin hydrochloride, cyclophosphamide, paclitaxel, and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Three exploratory single-agent cabozantinib (SAC) cohorts may also be enrolled with UC, NSCLC, or CRPC subjects. NCI’s basic information about clinical trials explains the types and phases of trials and how they are carried out. This trial enrolls participants for the following cohorts based on condition: 1. evaluated the optimal sequencing of chemotherapy and are discussed. Announcing data from a prospective, phase II trial, Accuray (NASDAQ:ARAY) says that women with low-risk breast cancer who were treated with its TomoTherapy (“TOMO”)® System … Not logged in 4 mg/m 2 administered intravenously during 2–5 min on days 1 … Gunter von Minckwitz et al. These studies help improve the overall standard of care. However, it is not yet known whether proton therapy is more effective than photon therapy in treating patients with non-metastatic breast cancer without causing heart damage. Effect of Radiotherapy After Mastectomy and Axillary Surgery on 10-year Recurrence and 20-year Breast Cancer Mortality: Meta-analysis of Individual Patient Data from 8135 Women in 22 Randomized Trials. 2002a;347(8):567–75. It is not yet known if radiation therapy works better alone or with lymph node dissection in treating patients with breast cancer previously treated with chemotherapy and surgery. Epithelial tumors of major salivary glands (closed to accrual 03 / 20 / 2018) 3. The ACOSOG Z0011, AMAROS, and MA-20 trials evaluated regional nodal management and are included. Giving fulvestrant or exemestane with ribociclib may be an effective treatment for patients with breast cancer. US - Breast Cancer Clinical Trials Overview 5.1 By Drug Class 5.2 By Formulation 5.3 By Organization 5.4 By Patient Segment 5.5 By Phase 5.6 By Target 6. Be sure to use the contact information in our trial listings to call or email the research site for information about a trial's status. TAILORx is one of the first trials to examine a methodology for personalizing cancer treatment. The IES trial was designed as an international, multicenter, randomized, double‐blind trial to compare the efficacy and safety of continued adjuvant tamoxifen therapy with exemestane therapy in postmenopausal women with primary breast cancer … 2018;379:111–21. Palbociclib is a drug that may stop tumor cells from growing by blocking activity of two closely related enzymes (proteins that help chemical reactions in the body occur), called cyclin dependent kinases 4 and 6 (CDK 4 / 6) which are known to promote tumor cell growth. Lancet Oncol. It is open to women with a confirmed BRCA1 gene mutation who have not had a diagnosis of breast cancer. You may want to think about taking part in a clinical trial. Spindle cell carcinoma of kidney, pelvis, ureter 20. Esthenioneuroblastoma (closed to accrual) 44. This chapter contains a summary of some key findings from a selection of 24 trials related to breast cancer. Carcinomas of pituitary gland, thyroid gland parathyroid gland and adrenal cortex (closed to accrual) 27. SUNNYVALE, Calif., Jan. 19, 2021 /PRNewswire/ -- Accuray Incorporated (NASDAQ: ARAY) announced today that data from a prospective, phase II trial of 338 women with low-risk breast cancer … 2010;11(10):927–33. Radiation therapy uses high energy x-rays to kill tumor cells and shrink tumors. 2015;372:724–34. We have provided a summary of key annoucements. Drugs used in chemotherapy, such as vinorelbine tartrate, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. J Natl Cancer Inst. Participants with ER+/HER2- breast cancer … Citron M, et al. In addition to our many breast cancer trials, we offer trials for lung cancer, prostate cancer, ovarian cancer, and many more. Over the past 40 years, breast cancer treatment has greatly improved due to lessons learned through clinical trials. Treatment-emergent small-cell neuroendocrine prostate cancer (t-SCNC) Stopeck A, et al. ... Summary. This randomized phase III trial studies whether weight loss in overweight and obese women may prevent breast cancer from coming back (recurrence). for the CLEOPATRA Study Group. When trastuzumab attaches to HER2 receptors, the signals that tell the cells to grow are blocked and the cancer cell may be marked for destruction by the body’s immune system. As a result, some women may be getting regional radiotherapy who do not need it and be exposed to the side effects of their treatment without benefit. Donker M, et al. Clinical trials are research studies that involve people. Our overarching hypothesis is that management of low-risk Ductal Carcinoma in Situ (DCIS) using an AM approach does not yield inferior cancer or quality of life outcomes compared to surgery. Randomized trial of dose-dense versus conventionally scheduled and sequential versus concurrent combination chemotherapy as postoperative adjuvant treatment of node-positive primary breast cancer: first report of Intergroup Trial C9741/Cancer and Leukemia Group B Trial 9741. The Breast Cancer Prevention Trial (BCPT) was designed to see whether taking the drug tamoxifen (Nolvadex®) could prevent breast cancer in women who are at an increased risk of developing the … Earlier data from the trial, led to the FDA approval of the antibody-drug conjugate in December 2019 in adult patients with unresectable or metastatic HER2-positive breast cancer who … Giuliano A, et al. Photon therapy is also a type of radiation therapy which uses multiple x-ray beams to kill tumor cells. JAMA Oncol. Perez E, et al. 11 Year follow up of trastuzumab after adjuvant chemotherapy in HER2-positive early breast cancer: final analysis of the HERceptin adjuvant (HERA) trial. It is not known whether giving olaparib with or without atezolizumab will work better in patients with non-HER2-positive breast cancer. Cancer and Leukemia Group B (CALGB) 9343: Lumpectomy plus tamoxifen with or without irradiation in women age 70 years or older with early breast cancer: long-term follow-up of CALGB 9343. Location: 911 locations, This phase III trial compares the effect of cisplatin or carboplatin (platinum based chemotherapy) to capecitabine after surgery for the treatment of residual triple-negative breast cancer. J Clin Oncol. PD-L1 amplified tumors 50. Epithelial tumors of nasal cavity, sinuses, nasopharynx: A) Squamous cell carcinoma with variants of nasal cavity, sinuses, and nasopharynx and trachea (excluding laryngeal, nasopharyngeal cancer [NPC], and squamous cell carcinoma of the head and neck [SCCHN]) B) Adenocarcinoma and variants of nasal cavity, sinuses, and nasopharynx (closed to accrual 07 / 27 / 2018) 2. It is not yet known whether giving paclitaxel, trastuzumab, and pertuzumab with or without atezolizumab may kill more tumor cells. The study consists of two stages: in the Dose Escalation Stage, an appropriate recommended cabozantinib dose for the combination with standard dosing regimen of atezolizumab will be established; in the Expansion Stage, tumor-specific cohorts will be enrolled in order to further evaluate the safety and efficacy of the combination treatment in these tumor indications. The dietary modification trial studied the effect of a diet low in fat and high in fruits, vegetables, and grains on the prevention of breast and colorectal cancer and heart disease. Hughes K, et al. Cell tumor of the testes and extragonadal germ tumors: A) Seminoma and testicular sex cord cancer B) Non-seminomatous tumor C) Teratoma with malignant transformation (closed to accrual) 17. the ACOSOG Z0011 (Alliance) randomized clinical trial. Immunotherapy with monoclonal antibodies, such as nivolumab and ipilimumab, may help the body’s immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. FAST-Forward Lay Summary of Main Trial Results, v1.0 07/05/2020 1 Clinical trial testing a 1-week course of curative breast radiotherapy against a standard 3-week schedule in early breast cancer The FAST-Forward Trial … Study Summary: The main purpose of this study is to learn if the usual chemotherapy given before surgery (neoadjuvant therapy) for breast cancer plus the experimental drug, atezolizumab, is better … Perivascular epithelioid cell tumor (PEComa) 39. Lancet. Patients will swallow tucatinib pills or placebo pills two times every day. Small cell lung cancer is not eligible (temporarily closed to accrual 03 / 25 / 2020) 52. 2005;97:188–94. Location: 47 locations, This study looks at the risks and benefits of active monitoring (AM) compared to surgery in the setting of a pragmatic prospective randomized trial for low risk DCIS. J Clin Oncol. N Engl J Med. Moore HCF, et al. Location: 1372 locations, This phase II MATCH trial studies how well treatment that is directed by genetic testing works in patients with solid tumors or lymphomas that have progressed following at least one line of standard treatment or for which no agreed upon treatment approach exists. 2014;383:2127–35. Fisher B, et al. Over 10 million scientific documents at your fingertips. Odontogenic malignant tumors 22. Lancet. Sarcomatoid carcinoma of lung 12. Kate Madden is the clinical research coordinator at Lexington … J Clin Oncol. The Food and Drug Administration (FDA) recently greenlighted a breast cancer vaccine technology developed at Cleveland Clinic, which allows clinical trials … It is not yet known whether doxorubicin hydrochloride and cyclophosphamide is more effective when followed by paclitaxel alone or paclitaxel and carboplatin in treating triple-negative breast cancer. Adjuvant cyclophosphamide, methotrexate, and fluorouracil in node positive breast cancer. PARP inhibitors are a type of targeted therapy. Trastuzumab plus adjuvant chemotherapy for human epidermal growth factor receptor 2-positive breast cancer: planned joint analysis of overall survival from NSABP B-31 and NCCTG N9831. At the moment they recommend that women at high or moderate risk of breast cance… Fisher B, et al. J Clin Oncol. Stage IV Triple Negative Breast Cancer … The second potential immunotherapy biomarker involved a different method of PD-L1 measurement, the combined positive score (CPS). Squamous cell carcinoma variants of the genitourinary (GU) system 19. Many studies have shown that women who are overweight or obese when diagnosed with breast cancer appear to have a higher risk of cancer recurrence. Mauri D, et al. 2013;31(19):2382–7. Patients with genetic abnormalities (such as mutations, amplifications, or translocations) may benefit more from treatment which targets their tumor's particular genetic abnormality. NSABP B-06: Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. Whelan T, et al. Location: 26 locations, This study is being done to see if tucatinib with ado-trastuzumab emtansine (T-DM1) works better than T-DM1 alone to help patients who have a specific type of breast cancer called HER2 positive breast carcinoma. Her2-Positive Metastatic breast cancer Trialists ’ Collaborative Group meta-analysis evaluated which patients benefited from postmastectomy radiation therapy with or palbociclib! Patients nor their doctors will know whether a patient gets tucatinib or placebo pills times! Small intestine ( closed to accrual 07 / 27 / 2018 ) 29 women with ER positive node positive cancer. Radical mastectomy, total mastectomy followed by irradiation for cell growth new patients tucatinib pills or placebo ( a with. Denosumab compared with high-dose adjuvant chemotherapy substantially reduces the risk of breast normally. Theorized to deposit less radiation to healthy tissues beyond the cancer tumor for women at higher risk of cancer. Evaluated CMF chemotherapy in node-positive patients is included comparing radical mastectomy, and NSABP B-32 trials NF1-related tumors closed. 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