Revised text to state that one study of 115 U.S. pathologists reported that study pathologists agreed with an expert consensus diagnosis of atypia only 48% of the time (cited Silverstein, Recht, et al. as reference 14 and Silverstein et al. as reference 15).
Added text to state that to address the high rates of discordance in breast tissue diagnosis, laboratory policies that require second opinions are becoming more common; a recent national survey of 252 breast pathologists found that 65% of respondents reported having a laboratory policy that require second opinions for all cases initially diagnosed as invasive disease. Also added text to state that additionally, 56% of respondents reported policies that require second opinions for initial diagnosis of ductal carcinoma in situ, while 36% of respondents reported mandatory second opinion policies for cases initially diagnosed as atypical ductal hyperplasia; in this same survey, pathologists overwhelmingly agreed that second opinions improved diagnostic accuracy (cited Geller et al. as reference 23).
Revised text to state that overdiagnosed disease is defined as a neoplasm that would never become clinically apparent in the absence of screening.
Added text to state that a population study, comparing different counties in the United States, showed that higher rates of screening mammography use were associated with higher rates of breast cancer diagnoses, yet no corresponding decrease in 10-year breast cancer mortality was seen (cited Harding et al. as reference 27).
ver historia personal en: www.cerasale.com.ar [dado de baja por la Cancillería Argentina por temas políticos, propio de la censura que rige en nuestro medio]//
weblog.maimonides.edu/farmacia/archives/UM_Informe_Autoevaluacion_FyB.pdf - //
weblog.maimonides.edu/farmacia/archives/0216_Admin_FarmEcon.pdf - //
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