Centre Claudius-Regaud, 20-24, rue du Pont-Saint-Pierre, 31052 Toulouse Cedex, France.
In the field of breast cancer, clinical trials are more and more difficult to perform. In a first part, the effectiveness of the benefits are discussed as the respective implication of detection and therapeutics. For the later, the recent metaanalysis demonstrates a tiny absolute benefit. In a second part, some examples studies of which can improve the life span of patients are discussed. Only well-designed clinical studies are able to demonstrate any advantage drawn from new detection programs, adjuvant treatments or quality of life end points. In all cases, the number of subjects for these kinds of studies is larger and larger. Clinical research in breast cancer is in danger because of the increased treatment centers, the lack of cooperative groups and official support. Proposals are done for a stimulation of patient accrual.