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Meaning of Five-Year Cure in Cancer of the Breast

DOUGLASS G. WHITNEY, MD; ROGER F. SMITH, MD; D. EMERICK SZILAGYI, MD
Arch Surg. 1964;88(4):637-644. doi:10.1001/archsurg.1964.01310220127020.
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In recent years the rationale of the use of the classical radical mastectomy in the treatment of cancer of the breast has been questioned on several and often contradictory grounds: it has been judged both inadequate and excessively radical, and has also been pronounced essentially ineffective.1,12,16 On examining the evidence, it is not difficult to see that the statistical foundation of much of this criticism is unconvincing. All too often data unsuited for comparison are compared, significant factors bearing on results neglected, and the vagaries of the biological behavior of breast cancer ignored. The influence on statistical inference of the last named factor is of particular interest since it profoundly affects the significance of the socalled five-year cure, an almost universal measuring standard of therapeutic success. In studying the late (post-five-year) survival of our patients we have been impressed by the importance of this factor and by the need

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