Radiation Therapy for in Situ or Localized Breast Cancer

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Abstract
In the study by Fisher et al. (June 3 issue)1 of lumpectomy compared with lumpectomy and radiation therapy for the treatment of intraductal breast cancer, more than 20 institutions enrolled 818 women, and the diagnosis of breast cancer was made by institutional pathologists. There was apparently no central pathology review. The ability of pathologists to categorize in a reproducible way proliferative lesions of the breast and the distinction between intraductal breast cancer and ductal hyperplasia are matters of concern2. We believe that misclassification of patients has not been excluded as a possible explanation for the benefit reported in the group treated with radiotherapy.