To the Editor.—
The important debate over adjuvant chemotherapy in breast cancer continues. The recent article by Packard et al (238:1034-1036, 1977) presents data on relapses. However, it is unclear as to how vigorously relapses were sought. For example, bone scans are important in detecting early bone lesions.1 As we all realize, the incidence of a finding reflects the diligence with which it is sought. Before accepting any of the authors' data, we should appreciate some delineation of what methods were used in the detection of relapses.
Feiner A, Mahmood T. Relapses of Breast Cancer. JAMA. 1978;239(1):25. doi:10.1001/jama.1978.03280280025010