Abstract
To the Editor. —Some comments regarding radiation therapy made in the recent Clinical Crossroads on DCIS 1 could use clarification. The NSABP B-17 protocol was a trial designed to evaluate the difference between lumpectomy alone and lumpectomy with radiation therapy in women presenting with DCIS. The results, published in 1993, 2 clearly show an advantage with radiation. Five-year event-free survival was better in women who received radiation therapy, and this improvement was attributable to a reduction in ipsilateral local recurrence. With surgery alone, 16% of women had ipsilateral recurrences, and the recurrences were evenly divided between invasive and noninvasive types. However, only 7% of women treated with surgery and radiation developed ipsilateral recurrence, and most of these (20 [71%] of 28) were noninvasive, ie, more DCIS. This resulted in a statistically significant reduction in invasive breast cancer recurrence. When discussing the risks of radiation-induced cancers, Dr Morrow comments on a
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