Dr Gordon in her letter correctly highlights that the guidelines published in our recent article in the BCMJ are out of date.
When we submitted the manuscript we appended the guidelines as they were at the time of the data capture as that seemed appropriate, but we stand corrected that current information may be more helpful for the readership. The BCCA guidelines were updated last year; it was anticipated that they would be electronically available a number of months ago but due to complexities were not.
The revised and approved new guidelines will be mounted electronically this month and will have the updated information as documented by Dr Gordon. What concerned us and prompted the research study, however, was that the existing guidelines were not being followed, let alone tougher guidelines including the current BCCA guidelines or international standards.
Our research study emphasized what is happening with breast cancer screening and diagnosis in BC. Although in the past there was controversy over the impact of screening mammography, population studies showing an improvement in survival due to early diagnosis from screening should close the argument.
We need the medical community to clearly and unambiguously advise women to participate and we need to increase attendance at the SMPBC. As well, despite improvements in diagnosis, many women are not getting the proper investigations done in a clear and timely fashion.
Highlighting the need for specialized imaging and prompt core biopsies of the suspicious lesions as documented by both Dr Gordon and our new guidelines are of great importance. We thank Dr Gordon for drawing attention to the updated guidelines.
Early diagnosis does make a difference, and in BC we should be doing better if we want to improve outcomes. With our SMPBC program and our dedicated imaging experts we can achieve this.
—Karen A Gelmon, MD
—Barbara Poole, MPA
Above is the information needed to cite this article in your paper or presentation. The International Committee
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Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
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