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To the Editor: Mr Riley and colleagues¹ identified a significant increase of breast-conserving surgery (BCS) as well as of radiation therapy following BCS from 1988 to 1993 in the Surveillance, Epidemiology, and End Results (SEER) program linked to Medicare enrollment records. In our recent analyses using the SEER Public Use Data Set, we found that the use of BCS without radiation therapy has, in fact, also increased over time. We identified 35,267 women who were diagnosed as having local or regional stage breast cancer at age 65 years or older between 1988 and 1993 and had either a mastectomy or BCS (the definition of the surgery was the same as reported by Riley et al). The percentage of BCS increased from 23.1% in 1988 to 40.5% in 1993. Of 11,409 patients who received BCS, the use of radiation after BCS increased from 57.7% in 1988 to 63.9% in 1993. Ironically, . . . [Full Text of this Article]