In Reply.—I have read Dr Levitt's articles and I stand by my editorial comment. Achievement of local control by radiation therapy or operation in a patient with disseminated breast cancer is of secondary importance to control of distant metastases, which requires a systemic therapy. The caveat about a possible decreased survival rate associated with radiation therapy was properly and conservatively stated.
Dr Levitt brings to the Archives a debate he has carried out in another journal. For a balanced review of the subject, a list of additional references that will follow are recommended to the reader.