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Breast Cancer Often Over Diagnosed

The New York Times published findings which support the contention that pathologists are misdiagnosing breast cancer at alarming rates. Ductal carcinoma in situ, or D.C.I.S. is the earliest form of detectable breast cancer.

The Times examined various breast cancer cases and concluded that diagnosing early stages of breast cancer requires a higher degree of experience than previously understood. Because technology has advanced the science of mammography, results of tissue samples have become more difficult for an ordinary pathologist to read. Lesions (small cellular lumps) are now detectable on film as small as a grain of salt. When biopsied the difference between a benign and non benign lesion has become  more difficult to determine. As many as 17% of cases identified may be misdiagnosed, the Times reported:

"Despite this, there are no mandated diagnostic standards or requirements that pathologists  performing the work have any specialized expertise, meaning that the chances of getting an accurate diagnosis vary from hospital to hospital."

This study comes on the heels of a report issued in November by the United States Preventive Task Force suggesting that screening by mammography in younger women may have more risk than benefit. D.C.I.S. or non invasive cancer is diagnosed in over 50,000 patients a year. Before the use of mammography this type of cancer could only be diagnosed by physical palpation in the presence of a noticeable lump. The report states that if left untreated the cancer will become invasive in 30% of the cases. The College of American Pathologist is starting a certification program that will require pathologists who read breast tissue to look at least 250 cases a year to insure the proper level of experience. Certain doctors have willingly acknowledged that there is a problem. We suggest to all our clients at Cohen & Feeley that they insist that their pathologist has the required training if a reading of breast tissue is indicated. Dennis F. Feeley

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