Over the past ten years, conservative surgery and radiation therapy has become a widely employed treatment for patients with early breast cancer. This use has been based on the results of both retrospective1-6 and prospective7-10 clinical studies, which demonstrated that high levels of local tumor control and good cosmetic results can be achieved and that the survival results to date are comparable with those seen with mastectomy (Tables 1 and 2).
In his editorial in this issue of the Archives, Dr Friedman raises a number of concerns regarding the use of conservative surgery and radiation therapy. We agree that further study is required to more firmly establish criteria for patient selection, guidelines for the extent of surgery to be employed prior to radiation, and rules for the doses and volumes to be irradiated. These issues, however, need to be investigated by carefully implemented long-term studies, not by anecdotes