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April 5, 2000

Clinical Breast Examination for Detecting Breast Cancer

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(13):1687-1689. doi:10.1001/jama.283.13.1685

To the Editor: In their article on CBE, Dr Barton and colleagues1 arrived at conclusions that are not supported by the data. Two of the authors have opposed mammographic breast cancer screening for women aged 40 to 49 years2 despite evidence demonstrating its efficacy and based on inappropriate subgroup analysis of data lacking statistical power, and they continued to do so despite the demonstration of significant benefit.3 These authors have (legitimately) argued for proof of benefit from randomized controlled clinical trials with regard to mammography but do not require such data for CBE. In their present article, they are content to support screening CBE despite the lack of any direct evidence (significant or not).

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