In Reply We thank Lin and colleagues for the comments on our study comparing survival following breast conservation vs mastectomy. As the authors confirm, whole-breast radiotherapy was a requirement for all individuals in our study undergoing breast-conserving surgery, and those in whom it was omitted (n = 2390) were excluded from analysis. Although we agree that the register we used does not give full details on given radiotherapy, we are confident that we can discern local (ie, whole-breast after breast-conserving surgery or chest wall after mastectomy) from locoregional radiotherapy (including the above-local target but adding regional nodal fields). In a 2021 publication from our group using the same Swedish national register, we individually scrutinized the medical records of 4294 patients undergoing breast-conserving surgery from 2010 to 2016 and found that dose and fractionation rarely differed from guideline recommendations. Hence we are confident that deviations from the standard dose (50 Gy, with an additional boost dose for those younger than 50 years) and fractionation (n = 25) were uncommon in our study. During the relevant years (2008-2017), partial breast irradiation was not used in Sweden. Thus, the present study does not and cannot make any assumptions regarding the advantages or disadvantages of partial breast irradiation, and we cannot underpin or contradict the statement by Lin and colleagues regarding the cosmetic benefits of such radiotherapy. That is assuming that the term locoregional radiotherapy in their Letter indeed regards partial breast irradiation according to the Intraoperative Irradiation for Early Breast Cancer (ELIOT) trial and not true locoregional radiotherapy as defined above.

中文翻译：

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在保乳手术中根除潜在的转移性转移——回复

作为回复，我们感谢 Lin 及其同事对我们比较保乳与乳房切除术后生存率的研究发表的评论。正如作者所证实的，全乳放疗是我们研究中接受保乳手术的所有个体的要求，而那些被省略的个体（n = 2390）被排除在分析之外。虽然我们同意我们使用的登记册没有提供给定放射治疗的全部细节，但我们有信心我们可以从局部区域放射治疗（包括上述-局部目标，但添加区域节点场）。在我们小组 2021 年使用相同的瑞典国家登记册发布的出版物中，我们分别审查了 2010 年至 2016 年接受保乳手术的 4294 名患者的医疗记录，发现剂量和分割很少与指南建议不同。因此，我们相信在我们的研究中，偏离标准剂量（50 Gy，对 50 岁以下的人额外加强剂量）和分割（n = 25）并不常见。在相关年份（2008-2017 年），瑞典未使用部分乳房照射。因此，本研究没有也不能对部分乳房照射的优点或缺点做出任何假设，我们不能支持或反驳 Lin 及其同事关于这种放射治疗的美容益处的陈述。