Breast Cancer Screening and Diagnosis
Authors: Karsten J. Jørgensen, Asger S. Paludan-Müller
Journal: Annals of Internal Medicine (2020)

Letters16 June 2020Breast Cancer Screening and DiagnosisKarsten J. Jørgensen, MD, DrMedSci and Asger S. Paludan-Müller, MScKarsten J. Jørgensen, MD, DrMedSciNordic Cochrane Centre, Copenhagen, Denmark (K.J.J., A.S.P.)Search for more papers by this author and Asger S. Paludan-Müller, MScNordic Cochrane Centre, Copenhagen, Denmark (K.J.J., A.S.P.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-0253 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read the European Commission Initiative on Breast Cancer's (ECIBC's) guideline (1) with interest. A great strength of the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach is that it makes the necessarily subjective judgments made by guideline panels transparent. This allows for discussion of each step in the process, from evidence to recommendation.The original evidence profiles for the ECIBC Screening and Diagnosis guidelines indicate that the certainty of the estimate of the most serious harm of breast cancer screening—overdiagnosis—was downgraded to moderate because of the age of the trials (indirectness) (2). This is reasonable, ...References1. Schünemann HJ, Lerda D, Quinn C, et al; European Commission Initiative on Breast Cancer (ECIBC) Contributor Group. Breast cancer screening and diagnosis: a synopsis of the European Breast Guidelines. Ann Intern Med. 2020;172:46-56. [PMID: 31766052]. doi:10.7326/M19-2125 LinkGoogle Scholar2. European Commission Joint Research Centre. European Commission Initiative on Breast Cancer (ECIBC): European guidelines on breast cancer screening and diagnosis. 2019. Accessed at https://healthcare-quality.jrc.ec.europa.eu/sites/default/files/Guidelines/EtDs/ECIBC_GLs_EtD_screening_50-69.pdf on 5 May 2020. Google Scholar3. Autier P, Boniol M, La Vecchia C, et al. Disparities in breast cancer mortality trends between 30 European countries: retrospective trend analysis of WHO mortality database. BMJ. 2010;341:c3620. [PMID: 20702548] doi:10.1136/bmj.c3620 CrossrefMedlineGoogle Scholar4. Gøtzsche PC, Jørgensen KJ. Screening for breast cancer with mammography. Cochrane Database Syst Rev. 2013:CD001877. [PMID: 23737396] doi:10.1002/14651858.CD001877.pub5 CrossrefMedlineGoogle Scholar5. Iorio A, Spencer FA, Falavigna M, et al. Use of GRADE for assessment of evidence about prognosis: rating confidence in estimates of event rates in broad categories of patients. BMJ. 2015;350:h870. [PMID: 25775931] doi:10.1136/bmj.h870 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Nordic Cochrane Centre, Copenhagen, Denmark (K.J.J., A.S.P.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L20-0253. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoBreast Cancer Screening and Diagnosis: A Synopsis of the European Breast Guidelines Holger J. Schünemann , Donata Lerda , Cecily Quinn , Markus Follmann , Pablo Alonso-Coello , Paolo Giorgi Rossi , Annette Lebeau , Lennarth Nyström , Mireille Broeders , Lydia Ioannidou-Mouzaka , Stephen W. Duffy , Bettina Borisch , Patricia Fitzpatrick , Solveig Hofvind , Xavier Castells , Livia Giordano , Carlos Canelo-Aybar , Sue Warman , Robert Mansel , Francesco Sardanelli , Elena Parmelli , Axel Gräwingholt , Zuleika Saz-Parkinson , and Breast Cancer Screening and Diagnosis Zuleika Saz-Parkinson , Stephen W. Duffy , Carlos Canelo-Aybar , Axel Gräwingholt , Cecily Quinn , Markus Follmann , and Holger J. Schünemann Breast Cancer Screening and Diagnosis Hans-Olov Adami and Philippe Autier Metrics Cited byDevelopment and Validation of a Prognostic Classifier Based on Lipid Metabolism-Related Genes for Breast Cancer 16 June 2020Volume 172, Issue 12Page: 838-839KeywordsBreast cancerBreast cancer screeningCancer treatmentConflicts of interestDisclosureGrading of Recommendations Assessment Development and EvaluationMortalityRandomized trialsScreening guidelines ePublished: 16 June 2020 Issue Published: 16 June 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...