To the Editor.—Ghossein et al,1 in the August 1987 issue of the Archives, questioned whether it is necessary to irradiate the breast after conservative surgery for localized cancer. They reported on 324 patients treated at the Institut Curie in Paris with segmental resection and postoperative radiation therapy. They concluded that "patients who do not develop local recurrence have a greater chance of remaining free of distant dissemination than patients who develop recurrences in the breast, particularly if the failure occurs within five years."
One of Ghossein's coauthors, Vilcoq, in another article reporting on 324 patients from the same institution, joined others in pointing out that most early recurrences were in patients under 33 years of age.2 They concluded that "loco-regional recurrence, when found at an early stage... does not [emphasis added] influence survival."
Thus, the evaluation of one group of patients had led to two contradictory conclusions;