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Volume 357:1051-1052 September 6, 2007 Number 10
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Local Therapy and Survival in Breast Cancer

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by Punglia, R. S.
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To the Editor: One of the shortcomings of the article on local therapy and survival in breast cancer, by Punglia et al. (June 7 issue),1 is the claim that a decrease in breast-cancer mortality and overall mortality as a result of radiation therapy "firmly support[s] a causal link between local control and overall survival in some patients." Although surgical removal of the breast is the most effective method of local control, the authors' statement that "pooled analyses of randomized trials comparing mastectomy with breast-conserving therapy have shown equivalent survival" is contrary to that thesis. In the Early Breast Cancer Trialists' . . . [Full Text of this Article]



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