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In Reply: Mr Anesi underscores a key point in our Commentary. It is entirely possible that genomic profiling or other developing technologies will guide better patient selection for systemic therapy for breast cancer. That is why we emphasize the appropriateness of using preoperative chemotherapy in the context of clinical trials and urge community support for these efforts.

Financial Disclosures: Dr Hudis reported having equity in Genomic Health and receiving grant support from the Breast Cancer Research Foundation and the National Cancer Institute. Dr Modi reported receiving research support from Kosan Biosciences Inc and Genentech Inc.

Clifford A. Hudis, MD
hudis@mskcc.org

Shanu Modi, MD
Memorial Sloan-Kettering Cancer Center
Weill College of Medicine
Cornell University
New York, New York

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2008;299(13):1544.

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