The results of the surgical treatment of breast cancer at the Johns Hopkins Hospital revealed that the five-year survival rate for radical mastectomy was 52% and the ten-year survival rate was 33%. These results were reviewed and compared with prior time periods and only a slight increase in the survival rate was noted. The most impressive feature of the surgical treatment of breast cancer is the striking similarity and surprising uniformity of long-term end results despite widely differing therapeutic techniques as reported from this country and abroad. Further comparisons between individual series differing in composition, classification, and case selection will never resolve our divergent differences of opinion. There is an urgent need for a large cooperative and randomized clinical trial designed biometrically to compare the results of alternative and equivalent surgical procedures in the treatment of breast cancer.