* 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.
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.