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August 23, 1976

Leukopenia After Postmastectomy Irradiation

Author Affiliations

Virginia Commonwealth University Medical College of Virginia Richmond

JAMA. 1976;236(8):916. doi:10.1001/jama.1976.03270090012006

To the Editor.—  With reference to the article, "Leukopenia After Postmastectomy Irradiation" (235:747, 1976) by Lewis and Patterson, it has been previously noted by others that transient leukopenia is found in some women after irradiation of the internal mammary nodes for carcinoma of the breast. Drs Lewis and Patterson again confirm this phenomenon and raise provocative questions of concern to those of us responsible for deciding whether the patient requires radiation. The inference that radiation therapy results in an impaired immune response, a greater incidence of systemic metastasis, or in secondary cancers—or that it may compromise prophylactic chemotherapy—has not been demonstrated. To the contrary, postoperative radiation has improved the survival rate for some patients receiving mediastinal irradiation, ie, for bronchogenic carcinoma; and the combination of radiation therapy and chemotherapy has improved results with several tumors, eg, oat-cell carcinoma of the lung and advanced Hodgkin disease. Furthermore, postmastectomy irradiation can eradicate