SUMMARY

In conclusion:

  * During the last two decades, as a result of the use of systemic therapy in conjunction with breast-conservation surgery and radiation therapy, the incidence of locoregional recurrence has been reduced to a level where further reduction, a goal worthy of achieving, is likely to have little impact on survival.
  * Despite the extensive information presented in this commentary, there is no new scientifically based evidence to justify replacing the current breast cancer hypothesis.
  * It is likely that findings from research related to molecular biology and genetics will be the source of information that will result in a new, testable thesis that will eventually replace the alternative hypothesis and thus the paradigm that currently governs the treatment of breast cancer.

AUTHOR CONTRIBUTIONS

Conception and design: Bernard Fisher, Stewart J. Anderson

Manuscript writing: Bernard Fisher, Stewart J. Anderson

Final approval of manuscript: Bernard Fisher, Stewart J. Anderson

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Bernard Fisher, Stewart J. Anderson

From the Departments of Surgery and Biostatistics, University of Pittsburgh, Pittsburgh, PA.
Corresponding author: Bernard Fisher, MD, Department of Surgery, University of Pittsburgh, Forbes Tower, Ste 7098, 200 Lothrop St, Pittsburgh PA 15213; e-mail: .(JavaScript must be enabled to view this email address).