Breast Cancer · Medical · Adjuvant Chemotherapy
DBCG 77B
In high-risk breast cancer, does adjuvant chemotherapy improve survival compared with postoperative radiotherapy alone?
Tumour site
Breast Cancer
Discipline
Medical
Clinical setting
Adjuvant Chemotherapy
Evidence type
Comparative clinical evidence
Absolute Effect
DBCG 77B randomized 1,034 high-risk patients after mastectomy and postoperative radiotherapy to no systemic therapy, cyclophosphamide, or CMF. At 10 years, survival was 45%, 60%, and 62%, respectively. This is foundational randomized evidence for adjuvant chemotherapy in high-risk breast cancer.
NNT / NNH: Calculated only when a defensible fixed-time absolute event difference is available. Hazard ratios alone are not converted into NNT.
Clinical interpretation
The trial supports the historical principle that adjuvant chemotherapy can improve long-term outcomes in high-risk breast cancer, but its regimen is not a contemporary subtype-specific treatment guide.
Limitations
The study predates modern endocrine, HER2-directed and taxane-based therapy; current decisions must be based on tumour biology and present-day risk assessment.