As another medical oncologist with a special interest in breast cancer, I can empathize with Dr. Susan Rosenthal's "Parable of the Surgeon and the Internist" [1]. Patients diagnosed with breast cancer must be educated about and participate in decisions regarding treatment options during a most trying period in their lives. Surgeons, medical oncologists, and radiation oncologists must all possess outstanding communication skills and should consider themselves partners in this effort if progress against breast cancer is to be made.

Unfortunately, the literature on adjuvant treatment of breast cancer is voluminous. Legitimate differences regarding the management of individual cases have been the subject of panel discussions at national meetings. The implication that our surgical colleagues are less sophisticated in their approach to patients with breast cancer is untenable. Much of the research that forms the basis for our current standards of practice comes from the work of the National Surgical Adjuvant Breast and Bowel Project. This organization was started by a group of surgeons to compare mastectomy with more circumscribed surgery and continues to enroll more patients than any other cooperative group in trials to examine the effect of perioperative therapy on relapse rates.

Through active participation in tumor boards, grand rounds, and multispecialty clinics, we can ensure that all opinions are seriously considered and that patients benefit from our combined experience. Rather than publish derogatory statements focused at our surgical colleagues in prestigious internal medicine journals, we would do better to explore additional ways to improve communication and work together.