FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 356:2399-2405 June 7, 2007 Number 23 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF PDA Full Text PowerPoint Slide Set CME Exam Purchase this article Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

The effect of local therapy on the survival of patients with breast cancer has been debated for decades. Three viewpoints have been proposed on the basis of various hypotheses concerning the biology of breast cancer. Is breast cancer a local disease that spreads predictably over time to develop distant metastases? Is it a systemic disease from the outset, with distant metastases present well before diagnosis? Or is the truth somewhere in between, with many cancers being localized at diagnosis and, if untreated or recurrent, acquiring the ability to metastasize and kill? These differing views have vastly different implications for the . . . [Full Text of this Article]

Three Theories of Cancer Spread

Evidence from Clinical Trials

Benefits from Improved Local Control

Understanding Recurrent Disease

Future Directions

Source Information

From the Departments of Radiation Oncology (R.S.P., J.R.H.) and Medical Oncology (E.P.W.), Dana–Farber Cancer Institute; Brigham and Women's Hospital (R.S.P., E.P.W., J.R.H.); and Harvard Medical School (R.S.P., E.P.W., J.R.H.) — all in Boston; and the Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia (M.M.).

Address reprint requests to Dr. Punglia at the Department of Radiation Oncology, Dana–Farber Cancer Institute, 44 Binney St., Smith 274, Boston, MA 02115, or at rpunglia@lroc.harvard.edu.

Related Letters:

Local Therapy and Survival in Breast Cancer
Fisher B., Anderson S. J., Cady B., Punglia R. S., Morrow M., Harris J. R.
Extract | Full Text | PDF  
N Engl J Med 2007; 357:1051-1052, Sep 6, 2007. Correspondence

This article has been cited by other articles:

• Liakakos, T., Roukos, D. H. (2008). More Controversy than Ever - Challenges and Promises Towards Personalized Treatment of Gastric Cancer. Ann. Surg. Oncol. 15: 956-960 [Full Text]  
• Theodore, L. (2008). Reexcisions in Breast-Conserving Surgery for Breast Cancer: Can They Be Avoided?. Ann. Surg. Oncol. 15: 945-946 [Full Text]  
• Liakakos, T., Baltogiannis, G. (2008). Reducing Local Recurrence after Breast-Conserving Surgery for Breast Cancer. Ann. Surg. Oncol. 15: 949-950 [Full Text]  
• Li, D., Li, Y., Wu, X., Li, Q., Yu, J., Gen, J., Zhang, X.-L. (2008). Knockdown of Mgat5 Inhibits Breast Cancer Cell Growth with Activation of CD4+ T Cells and Macrophages. J. Immunol. 180: 3158-3165 [Abstract] [Full Text]  
• Ziogas, D., Xeropotamos, N., Batsis, C. (2008). The Importance of Surgical Margin Control in Breast-Conserving Therapy. Ann. Surg. Oncol. 15: 659-660 [Full Text]  
• Galliher-Beckley, A. J., Schiemann, W. P. (2008). Grb2 binding to Tyr284 in T{beta}R-II is essential for mammary tumor growth and metastasis stimulated by TGF-{beta}. Carcinogenesis 29: 244-251 [Abstract] [Full Text]  
• Kaufman, E. L., Jacobson, J. S., Hershman, D. L., Desai, M., Neugut, A. I. (2008). Effect of Breast Cancer Radiotherapy and Cigarette Smoking on Risk of Second Primary Lung Cancer. JCO 26: 392-398 [Abstract] [Full Text]  
• Liakakos, T., Roukos, D. H. (2008). Does Lymphadenectomy Improve Survival of Patients with Solid Tumors?. Ann. Surg. Oncol. 15: 385-385 [Full Text]  
• Ziogas, D., Baltogiannis, G., Fatouros, M. (2008). Lymphadenectomy in Surgical Oncology. Ann. Surg. Oncol. 15: 386-387 [Full Text]  
• Fisher, B., Anderson, S. J., Cady, B., Punglia, R. S., Morrow, M., Harris, J. R. (2007). Local Therapy and Survival in Breast Cancer. NEJM 357: 1051-1052 [Full Text]