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Richard D. Corley, MD
Peoria, Ill

JAMA. 1995;274(5):380-381.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—The article by Dr Kattlove and colleagues¹ presents a basic benefit package for detection and treatment of early breast cancer. I believe this concept has many flaws. Implementation of this package takes the diagnosis and treatment of breast cancer out of the hands of the patient and her physician and transfers it into the hands of third-party payers.

I cannot agree with the authors' denying screening mammography for women younger than 49 years. Early-age screening mammography detects breast tumors that are small. This leads to a more favorable prognosis for the breast cancer patient.

Breast-conserving surgery for early cancer of the breast requires adjunct radiotherapy. Friedman² concluded from studying pathological tissues from 100 women who received radiation therapy that carcinoma of the breast cannot be considered a radiosensitive tumor. Radiation therapy produces initial fibrosis, loss of elasticity, fat necrosis, telangiectasia, lymphopenia, and obliterative arteritis. Tissue . . . [Full Text PDF of this Article]

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