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D B Kopans

Publications and source records attributed to D B Kopans.

At least 73 records · Page 4Linked to original sources
PubMed1995

Mammography screening and the controversy concerning women aged 40 to 49.

The screening controversy arose from inappropriate and scientifically insupportable data analysis of the early results from the randomized, controlled trials of screening. Data were used that were inadequate for making medical recommendations by using subgroup analyses from trials that were not designed to permit subgroup analysis by age. Contrary to suggestions made by some opposed to screening women younger than the age of 50, there are no parameters such as breast density, cancer detection rate, or positive predictive value that change abruptly at age 50 or any other age. The most recent meta-analysis provides statistically significant "proof" that screening can reduce the death rate from breast cancer by at least 24% for women aged 40 to 49.

Adult↗
PubMed1994

Screening for breast cancer and mortality reduction among women 40-49 years of age.

The recent withdrawal of screening support for women ages 40-49 years is not scientifically supported. The subgroup analyses that have been used severely compromise the statistical power of the trials. None of the trials has the statistical power to be able to provide clear proof of benefit for screening women ages 40-49 years because none of the trials involved sufficient numbers of women in these age groups. Despite having not been designed to evaluate women ages 40-49 years as a separate group, five of the eight randomized, controlled trials have demonstrated mortality reductions for these women that range from 22% to 49%. In addition, data from other nonrandomized trials show that there is no difference in survival for women ages 40-49 years than for women ages 50-59 years. The detection rate for small, early cancers, using modern mammography, is similar for women in both decades. There is no scientific reason to believe that there is a sudden change in detection or cure at age 50 years, or even at menopause. The available data suggest that women ages 40-49 years can benefit from screening, just as can women ages 50-59 years.

Adult↗
PubMed1994

A simple device to assist in needle positioning procedures.

At breast biopsy, use of a simple disk that fits into the hub of the needle can facilitate accurate placement of the needle with conventional lesion localization techniques. This disk forms a surface onto which the shadows of the localization crosshairs project so that the operator can advance the needle and maintain its alignment in the direction of the mammography beam by using the field light. The insert has been used successfully in more than 100 procedures.

Biopsy, Needle↗
PubMed1994

Caution on core.

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Biopsy, Needle↗
PubMed1994

Conventional wisdom: observation, experience, anecdote, and science in breast imaging.

Science is and should be the foundation of modern medicine, but observation and experience remain key elements in day-to-day clinical care. As mammography and other breast imaging techniques have evolved, early impressions have been replaced by more rigorous scientific testing, which has led to a more thorough understanding of the breast and the anatomic and morphologic origins of the imaging observations. As is true in many reports that involve the use of a new technique, early information is observational and anecdotal and frequently lacking the all-important "denominator" for a particular observation. For a "sign" to be accepted as a reliable indicator of a process, its associations must be compared with the overall prevalence of the observation in the healthy population. Observed associations must be corroborated by objective analysis.

Aging↗