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Correspondence
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Volume 347:2170-2171 December 26, 2002 Number 26
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Radical and Simple Mastectomy

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 by Fisher, B.
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To the Editor: Fisher et al. (Aug. 22 issue)1 report that radical mastectomy and total mastectomy are equally effective in terms of survival (equipotent) and interpret the small differences between the groups in their study as insignificant. We believe, however, that the trial in women with a clinically negative axilla was grossly undersized and that equipotency cannot be determined. A meta-analysis of trials addressing treatment of the axilla has shown a 5.4 percent (95 percent confidence interval, 2.7 to 8.0 percent) absolute benefit in survival.2

The authors state that a 5 percent difference is insignificant. The recent National Institutes of . . . [Full Text of this Article]




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