Oncology continues to be a discipline in which techniques of patient care are changing rapidly with the development of important new knowledge. While the original major treatment changes occurred in acute and rare diagnoses such as acute leukemia, lymphoma, Hodgkin's disease, and embryonal tumors, currently there have been rapid advances in the management of the more common malignant neoplasms.
When the diagnosis of breast cancer is established by biopsy, it is crucial to obtain fresh tissue for the determination of the presence of estrogen receptors in the primary cancer. Patients whose cancers lack estrogen receptors do not benefit appreciably from any type of hormonal manipulation, either additive or ablative.1 Women whose cancers have estrogen receptors are candidates for hormonal therapy. The drug tamoxifen, which functions as an antiestrogen, has proved to be effective hormonal therapy, particularly in postmenopausal women.2More important than the endocrine therapy considerations