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November 14, 1977

The Breast Cancer Controversy-Reply

JAMA. 1977;238(20):2142. doi:10.1001/jama.1977.03280210033004

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In Reply. —  I thank Mr Decker for his comments regarding our report on the stage characteristics of breast cancers diagnosed at our institution before and after November 1974. The point at issue was the influence, if any, of the unusual public and professional concern on the stage at diagnosis. Associated with the increased concern was an increased use of mammography and an increased use of diagnostic biopsy. Our study made no attempt to assess the independent influence of mammography on the decision to operate. Our findings indicate that the increased concern was not rewarded by a more favorable stage distribution either in the first six months or subsequently.Table 2 expands the period of study before and after November 1974. There is no substantial difference between the stage distribution in the different time periods. It is a disconcerting reality that, to date, attempts to control breast cancer by means