The National Surgical Adjuvant Breast and Bowel Project (NSABP) is a cooperative group that was formed in 1971 to conduct clinical trials in breast and colorectal cancer research. The members of this cooperative group had been involved in collaborative research as early as 1958. The cooperative group now comprises the membership of the NSABP Foundation, Inc. headquartered in Pittsburgh, Pennsylvania.

Current membership includes nearly 300 medical centers in the United States, Canada and Australia. Over 6000 physicians, nurses, and other medical professionals in the NSABP member institutions and their satellites conduct NSABP treatment and prevention trials. Members as a group represent a wide range of institutional types: major medical centers, university hospitals, large oncology practice groups, and health maintenance organizations. The majority are non-university centers which can make state-of-the-art clinical trials available to patients near their homes. Each member institution has, at a minimum, a designated principal investigator who is responsible for overall conduct of the study at his or her site, and a program coordinator who is designated as the primary contact for all NSABP-related administrative and logistical matters.

Institutional members conduct NSABP clinical trials including enrollment, protocol treatment, and submission of data for subjects and participants. Both the geographic accessibility to NSABP trials and the NSABP's track record of conducting clinically relevant, important, well-designed studies have contributed substantially to its success. In 1997, NSABP treatment trial members enrolled more than 3,000 breast and colorectal cancer patients in 7 treatment trials. During the height of recruitment to the Breast Cancer Prevention Trial, more than 9,000 participants were enrolled during a 12-month period.

The National Cancer Institute is the primary source of funding for NSABP Member institutions to conduct NSABP clinical trials. NCI funding also supports two headquarters components of the NSABP: the NSABP Operations Center at Allegheny University of the Health Sciences, Allegheny Campus; and the NSABP Biostatistical Center at the University of Pittsburgh. The Foundation also receives support from other sources for ancillary studies, training and educational programs.

Since 1958, the NSABP has played a vital role in improving the treatment of women with breast cancer. More recently, it has made contributions in the management of colon and rectal cancers. During this 40-year period, over 50,000 women and men were enrolled in NSABP clinical trials.

Results from NSABP clinical trials have been a major factor in altering breast cancer management. The most obvious change in the treatment of the disease has been the reduction in the extent of the operative procedures. NSABP trials were the first to demonstrate that the radical mastectomy was no more effective than less extensive procedures. After 10 years of follow-up, an NSABP study shows that patients treated by lumpectomy (a breast-conserving procedure) followed by breast irradiation have a survival prognosis similar to those treated by mastectomy. Due in large part to these findings, a National Institutes of Health consensus conference recommended that lumpectomy and breast irradiation be the procedure of choice for women with primary breast cancer.

The NSABP trials were among the first to evaluate the worth of systemic adjuvant chemotherapy for the treatment of breast cancer. Subsequent studies have evaluated hormonal therapies as well. Results from these trials indicated that such therapies reduce the recurrence rate of breast cancer and improve survival.

Thus as the NSABP enters its fortieth year, it can look back on a proud history of changing the way breast cancer is treated. . . and now, potentially, prevented. This cooperative group has established a long history of successfully conducting large-scale, randomized clinical trials for the treatment and, most recently, for the prevention of breast cancer. The group already has in place the supporting components including an NSABP Operations Center, an NSABP Biostatistical Center, and a dispersed membership necessary to conduct large clinical trials and related studies. Each of these components are necessary but the most important, and the one unique to this cooperative group, is a membership with demonstrated capabilities and commitment to complete the research studies undertaken.

For more information on the NSABP, visit their website here.

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