TY  - JOUR
T1  - BRachytherapy vs whole-breast irradiation for breast cancer—reply
AU  - Smith GL, Buchholz TA, Smith BD
Y1  - 2012/08/08
N1  - 10.1001/jama.2012.8490
JO  - JAMA
SP  - 567
EP  - 568
VL  - 308
IS  - 6
N2  - 
Khan et al correctly assert, as discussed in our article, that subsequent mastectomy could have been performed for indications other than local recurrence. They further contend, and we agree, that subsequent mastectomy due to treatment-related toxicity is rare. Instead, Khan et al posit that contralateral mastectomy accounts for a portion of the reported mastectomies. We are unaware, however, of any published literature to suggest that patients receiving brachytherapy are more apt than patients receiving WBI to undergo contralateral mastectomy, suggesting that the proportion of contralateral mastectomies should be the same for both treatment groups. This nondifferential misclassification would bias results toward the null. Accordingly, the premise of Khan et al actually suggests the increased risk of subsequent mastectomy in our analysis would underestimate the true relative recurrence risk after brachytherapy.

SN  - 0098-7484
M3  - doi: 10.1001/jama.2012.8490
UR  - http://dx.doi.org/10.1001/jama.2012.8490
ER  -