Between January 1947 and the end of 1976, of 2076 patients with Stages I and II breast cancer treated at M. D. Anderson Hospital, 126 received treatment for cancer in both breasts. Records of 94 patients who had only one cancer treated at U. T. M. D. Anderson Hospital and in whom staging and treatment details were not available and records of the patients who developed local, regional, or systemic failure prior to the diagnosis of the second breast were excluded. Of 126 patients with bilateral breast cancer, 39 had simultaneous tumors (both cancers diagnosed within six months) and 87 had consecutive tumors. The disease‐free 20‐year survival rate shows no significant difference between patients with unilateral tumors and those with bilateral simultaneous or consecutive tumors. Analysis by radiotherapy modality or surgery alone shows, if anything, a lower incidence of cancer in the second breast in the irradiated patients, indicating that in patients with Stage I or Stage II lesions, the doses of radiation given in the management of the first breast cancer were not conducive to the development of a cancer in the remaining breast.

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This article compares the outcome of 14 patients with primary refractory acute leukemia who underwent bone marrow transplantation from human leukocyte antigen (HLA)-identical donors with that of 18 age-matched control patients who received chemotherapy. Complete clearing of leukemia was seen in all 14 transplanted patients. Five of the transplanted patients are alive 98 to 1790 days posttransplant, and four are free of leukemia. Nine patients have died, eight with severe graft-versus-host disease associated with interstitial pneumonia or systemic infections and one with relapse from chemotherapy-associated infections. Engraftment was seen in all patients. Severe graft-versus-host disease (grades III and IV) was seen in ten patients and resolved in three patients following high-dose corticosteroid treatment. Three of the 18 control patients are alive, none of them in complete remission. It appears that the combination of piperazinedione and total-body irradiation followed by allogeneic transplant is effective induction treatment for primary refractory acute leukemia and will be considered in the future as first salvage treatment for patients failing induction treatment.

The combination of conservation surgery and radiation therapy for early breast cancer is gaining acceptance as an alternative to radical mastectomy. This article reviews the results of randomized trials showing that there is no advantage to a radical mastectomy in patients with early breast cancer. In addition, the article will review multiple reports concerning the local and regional tumor control and survival of patients treated with conservation surgery and irradiation as well as a comparison of 1073 patients with TIS T1 T2 N0 N1 breast cancer treated at University of Texas (UT) M. D. Anderson Hospital between 1955 and 1980, of whom 345 were treated with conservation surgery and irradiation and 728 were treated with radical or modified radical mastectomy alone. The locoregional recurrence in the patients treated with an intact breast is 4.9%, and 5.6% in patients treated with radical or modified radical mastectomy. There is no significant difference in the 10‐year disease‐free survival rates between the two groups of patients. In addition, a comparison of 2467 patients with Stage I and Stage II breast cancer treated at the UT M. D. Anderson Hospital shows no significant difference in the incidence of consecutive second breast carcinoma as a result of the use of radiation therapy in the treatment of the first breast cancer.