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August 8, 2012

Brachytherapy vs Whole-Breast Irradiation for Breast Cancer—Reply

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: University of Texas MD Anderson Cancer Center, Houston (

JAMA. 2012;308(6):567-568. doi:10.1001/jama.2012.8490

In Reply: Dr Khan and colleagues express concern about the validity of our outcome. Mastectomy is the most common salvage surgical procedure for local recurrence after brachytherapy.1 Prior studies internally validate subsequent mastectomy as a cancer outcome, demonstrating strong associations with known predictors of local recurrence, such as omission, delay, and incompletion of radiation therapy, large tumor size, estrogen receptor–negative status, and high grade.