I read with great interest the review by Christante et al1 and the thoughtful consideration of their work by Beatty.2 Dr Beatty notes that more than half of the patients in the Christante et al group did not have a tumor size greater than 5 cm, nor did they have 4 or more positive nodes. On this basis, Beatty suggests that we should decrease “unnecessary” postmastectomy radiation therapy. I challenge their definition of “unnecessary” postmastectomy radiation therapy, which they received from the American Society of Clinical Oncology guidelines formulated in 2001. Both Christante et al and Beatty consider this to be the best approach.
Evans SB. “Unnecessary” Postmastectomy Radiation Therapy. Arch Surg. 2011;146(6):764-765. doi:10.1001/archsurg.2011.131