by D.B. Kopans, MD, Breast Imaging Division, Department of Radiology, Massachusetts General Hospital, Avon Comprehensive Breast Center, Boston
Perspectives in Oncology, originally printed in Current Oncology
Additional confusion has been added to the “debate” about breast cancer. Women, their doctors, and the media are being misled, and women will die, unnecessarily, as a result. I recently outlined the scientific errors that I was concerned would be made by the U.S. Preventive Services Task Force (USPSTF) and the International Agency for Research on Cancer (IARC) panels in their reviews of breast cancer screening guidelines. Based on the draft proposal by the USPSTF, and now IARC, my concerns have been realized. Because the panels include few (if any) experts in screening, they are unable to sort out the validity of the various analyses involved, and they give credibility to analyses that have major flaws.
One of the other major problems with the panels is that their deliberations are held in secret. If anything should be completely transparent, it should be discussions of health care guidelines. It is my understanding that the IARC panel did not unanimously agree, and that a number of panel members felt that the data supported screening women starting at the age of 40. There should be transparency, and IARC should provide full disclosure, as well as any minority reports.