Challenges in Personalizing Decisions on Whole, Partial or No Breast Irradiation and Extent of Surgery for Early Breast Cancer

Excerpt

We would like to thank Tsekeris et al. for their helpful review of our recent report in the Annals of Surgical Oncology on outcomes of younger women treated with accelerated partial breast irradiation (APBI) with the MammoSite^® device on the Registry Trial.1 We would like to reiterate that our report was not meant to definitively assess the suitability of APBI in younger women. Certainly, the potential for hidden biases exists with any nonrandomized comparison. It should, however, be pointed out that the two cohorts, younger and older women, had comparable distributions of clinicopathological features which may contribute to the risk of local failure, and the overall population on the Registry Trial is relatively homogeneous. No attempt was made to control or to account for family history or histologic subtype (luminal A versus basal, etc.), nor to test patients for hereditary breast cancer genes. …