Recent results of surgical treatment of breast cancer at the Johns Hopkins Hospital reveal that the crude 5-year survival rate for radical mastectomy was 62.3% and that the crude 10-year survival rate was 48.7%. These results were compared with 3 prior time periods. Progressive improvement was noted despite the paradox of a uniform and level trend in our national mortality rates. The prognosis for Negro women appeared to be comparatively poor. A collective study of international 10-year survival rates was reviewed to compare the effectiveness of varying methods of treatment. The striking characteristic of these world-wide survival rates is their remarkable similarity regardless of the difference in the type of treatment. This concordance is true despite the dissimilarity of country or clinic being compared. A controlled clinical trial to evaluate the relative merits of equivalent methods of treatment must be undertaken as soon as possible. Randomized studies are urgently needed to assess the value of adjuvant therapy including castration, pre- or postoperative radiation therapy and chemotherapy.