Re: Breast cancer screening and diagnosis - Authors respond

We are pleased that our article on breast screening has created the interest and responses you have received. We of course agree with Dr Gardiner that participation rates over 90% would be optimal and have been achieved in a number of countries that are now reporting improvements in breast cancer survival. 

The goal of 70% is a preliminary goal and unfortunately predicated on issues such as the availability of mammography technologists. Ultimately the SMPBC and any screening program benefits from greater participation. As well as screening, though, it is clear that improvements in the survival for women with breast cancer have also been affected by adjuvant systemic therapy and, more recently, evidence for radiation therapy.[1,2]

The recommendations of the SMPBC are based on evidence. At this time there is no clear evidence for the optimal frequency of mammography, but we are awaiting those results.  Finally, the Breast Tumour Group does have guidelines for woman at high risk such as those with inherited genetic mutations that do combine mammography with MRI on an annual basis. 

At this time, the most important message is that screening mammo­graphy is being underutilized and, as Dr Gardiner suggests, this must be improved. 

—Karen A. Gelmon, MD FRCPC
—Barbara Poole, MPA
—Lisa Kan, MSc


1. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), Clarke M, Coates AS, Darby SC, Davies C, Gelber RD et al. Adjuvant chemotherapy in oestrogen-receptor-poor breast cancer: Patient-level meta-analysis of randomised trials. Lan­cet. 2008;371:29-40.
2. Olivotto I, Bajdik CD, Plenderleith IH, Coppin C, Gelmon K, Jackson SM, Ragaz J, Noble M, Worth A.  “Adjuvant systemic therapy and survival after breast cancer”  NEJM  1994;330(12):805-810.

Karen A. Gelmon, MD, FRCPC, Barbara Poole Lane, MPA, Lisa Kan, MSc. Re: Breast cancer screening and diagnosis - Authors respond. BCMJ, Vol. 50, No. 7, September, 2008, Page(s) 358 - Letters.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
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.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.

For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit

BCMJ Guidelines for Authors

Leave a Reply