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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.

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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

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