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LETTERS: H Gilbert Welch, Lisa M Schwartz, and Steven Woloshin Ramifications of screening for breast cancer: 1 in 4 cancers detected by mammography are pseudocancers BMJ 2006; 332: 727 [Full text]

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What is a pseudocancer?

David L Bisset   (24 March 2006)

What is a pseudocancer? 24 March 2006
David L Bisset, Consultant histopathologist Royal Bolton Hospital BL40JR Send response to journal: Re: What is a pseudocancer?	As a histopathologist who participates in the breast screening process, I am alarmed to read that "1 in 4 cancers detected by mammography are pseudocancers". Rapidly searching my textbooks I can't find descriptions of pseudocancers of the breast, and I dont know any pathologist who has made such a diagnosis. Perhaps you need to find a way of saying that 1 in 4 such cancers (which are true cancers) wont harm the patient during their lifespan. Before anyone gets too agitated, this is the dilemma at the heart of medical treatment: lots of patients have to be treated for only a few to benefit. The statistics for treatment of hypertension demonstrate this rather well, and if my arithmetic is correct, it would appear that for every 100 patients with early breast cancer treated with Herceptin only 8 will actually benefit (improvement of disease free survival in short studies from 77% to 85%). Competing interests: None declared