Kyndi M, Overgaard M, Nielsen HM et al.
Aarhus University Hospital, Aarhus, Denmark.
Radiother Oncol 2009;90:74–9.
Editor’s note: The latest major overview of adjuvant radiotherapy for breast cancer demonstrated a survival advantage for patients who received radiation treatment compared with those who did not (
Lancet 2005;366:2087–106). The authors of the overview explained this advantage by the Halstedian hypothesis that reduction of local recurrences prevents distant metastases and leads to a reduction in breast cancer-specific mortality. This was summarized by an equation stating that one breast cancer death was avoided for every four local recurrences avoided. The authors argued that large absolute reductions in local recurrence were seen only when the risk of recurrence was high and, consequently, that large reductions in breast cancer mortality rates can only be expected in populations at a high risk of recurrence.