This research proposal is designed to enable continued participation in the Primary Breast Cancer Therapy Group--NSABP. The overall specific aims of the NSABP are to improve disease-free survival and survival in patients with primary operable breast and colorectal cancers. (See the NSABP Headquarters grant application for protocol rationale and overall scientific achievements to date.) The Mt. Sinai Medical Center has been an NSABP member since February 1976 and has followed 394 patients previously randomized on long term adjuvant protocols. We expect to increase patient accrual to 85 per year. The entry of these patients into NSABP protocols will enable a more rapid and effective evaluation of current therapeutic regimens and will provide information for the design of future studies. The Mt. Sinai Medical Center is a health facility dedicated to assist with the care of Russian immigrants who enter into the United States through the Port of Cleveland. The Medical Center is located in a depressed urban area. The indigent population - the majority of which are blacks - utilize the institution's outpatient clinics. We serve the largest segment of the black population in Cleveland. The NSABP cooperative group allows us to deliver state of the art care to these patients with breast and colon cancer. Both of these minority groups have been represented in our patient accrual. Mt. Sinai is the nucleus for eight satellite institutions in a geographic radius of approximately 60 miles. In addition, the Principal Investigator limits his practice to only breast diseases, resulting in a large referral base which services an area with a radius of approximately 100 miles.
