Eight months after an NCI "Clinical Alert" was issued a survey was conducted to examine attitudes and practices regarding the use of adjuvant chemotherapy for node-negative breast cancer among Connecticut physicians most experienced in the care of such patients. Respondents (N = 66) indicated that the communication prompted change in case management practices; 65% reported increased use of adjuvant chemotherapy in treatment of women with node-negative disease. Seventy-seven percent of physicians who responded now consider adjuvant chemotherapy for node-negative patients to be the standard of care in their community. Opinions regarding the NCI strategy were more equivocal, with 44% of respondents terming the issuance of the Clinical Alert "inappropriate." Our findings suggest that real change in the treatment of breast cancer may have been precipitated by the NCI's action.
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