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August 15, 1977

Radiation and Breast Cancer

JAMA. 1977;238(7):579-580. doi:10.1001/jama.1977.03280070019006

To the Editor.—  We found the observations in Simon's article, "Breast Cancer Induced by Radiation" (237:789-790, 1977), to be quite interesting. Unfortunately his conclusions are not supported by the data. Specifically we would point out the following:

  1. The article ignores basic statistical and epidemiologic concepts in attributing breast cancer in 16 patients to prior irradiation for acne. We are not provided any denominator data to determine a population at risk, ie, those patients treated by irradiation for acne. Important questions are raised. From how large a breast cancer population were the 16 study cases extracted in this retrospective review, and how did they compare with the expected age-adjusted number of breast cancers in this group? How many women with acne were treated with chest irradiation, and how many breast cancers arose in that group, as compared with the nonirradiated group with acne? In other words, how many women treated