Dan Kopans

Physician and Professor of Radiology Harvard Medical School. Founder Breast Imaging Division Massachusetts General Hospital. Expert - breast cancer screening

[Dan Kopans @DrDkopans]

@susan_bewley @Melanie10120 @SharonO42821490 @bmj_latest @DrPaulaGordon As you indicate, screening is not perfect (seat belts don't save every life), but science has proven that thousands can be saved. The death rate has dropped dramatically, due to screening. The Cochrane review is scientific nonsense. The main author was dismissed from Cochrane.

[Dan Kopans @DrDkopans]

@MSKBreastImage @sloan_kettering @DrLizMorris We should use the money being wasted on TMIST to do an RCT of abreviated MR for general screening. My bet is we can almost eliminate deaths from breast cancer.

[Dan Kopans @DrDkopans]

You need to become informed. Randomized, controlled trials PROVED screening saves lives for ages 40-74 - confirmed by numerous observational studies; failure analysis; incidence of death studies. There are NO data to support the age of 50 as a threshold for screening.

[James Cave @JAHCave]

No it doesn’t- but it may make the most bucks for radiologists. The evidence is clear that mammography before 50 does not benefit women and may do more harm.

[Dan Kopans @DrDkopans]

@ESchattner @Kveller @ABatemanHouse Outrageous. Male doctors should always be chaperoned. One breast should always be covered. There is no need to cover the breast with gel. Add gel as needed. Cover the exposed breast during any pause and during discussion. Respect for all patients is nonnegotiable!

[Dan Kopans @DrDkopans]

@ESchattner @LindyWa @northjersey @thewisdomstudy @PCORI @RWJF The Wisdom Trial is based on false assumptions. Screening has been proven to reduce breast cancer deaths. There is no scientific basis for the trial. Allowing women to chose their allocation is a fundamental violation. The results will not be applicable to any other women.

[Dan Kopans @DrDkopans]

@thpmurphy @AP This has been clear to many of us for years. While we await the universal cure (not on the horizon), lives can be saved from breast cancer by screening and early detection. Instead of denigrating screening we need to support even better ways to find cancer when it is curable.

[Dan Kopans @DrDkopans]

40,000 women still die each year from breast cancer despite improvements in therapy. Our Harvard study (Webb,et al. A failure analysis of invasive breast cancer: Cancer. 2014 ) showed that 71% women who died from breast cancer were among the 20% not participating in screening.

[Dan Kopans @DrDkopans]

As far as Dr. Prasad's false claim that therapy is the reason for the major decline in deaths in the U.S. Therapy cannot cure advanced breast cancers. Treating breast cancers earlier is what saves lives.

[Dan Kopans @DrDkopans]

Dr. Prasad I would expect that a knowledgeable expert like yourself would not be afraid of a dumb radiologist and would unblock your Twitter feed. I am happy to have a direct discussion.

[Dan Kopans @DrDkopans]

Dr. Prasad is clearly awed by the NEJM despite its long history of bias against breast cancer screening refusing to publish papers supporting screening particularly for women ages 40-49 while publishing numerous, scientifically unsupportable, anti-screening papers like B&W's.

[Dan Kopans @DrDkopans]

Mammographically detected breast cancers do not disappear on their own!! Arleo et al. Persistent untreated screening-detected breast cancer: J Am Coll Radiol 2017; 14:863-867- Almost 500 untreated mammographically detected cancers. None had regressed or disappeared at follow-up.

[Dan Kopans @DrDkopans]

Prasad accepted the nonsense claim that the breast cancers in 70,000 women in 2008 alone would have disappeared had they not been found by mammography yet no one has ever seen a mammographically detected breast cancer disappear! 70,000 in one year yet not a single case??!!!

[Dan Kopans @DrDkopans]

Dr. Prasad did not look carefully at the data for women YOUNGER than 40. He was misled by the short scale missing the 1% APC of early and advanced cancers. Had B&W used this same baseline increase, they would have found no excess cancers and a major decline in advanced cancers!

[Dan Kopans @DrDkopans]

B&W and Prasad are wrong. They ignored the steady increase in invasive cancers back to 1940. Likely continuing, the annual average % increase (APC) of 1-1.3% means that there has been no excess of invasive cancers and the rate of advanced cancers has declined dramatically.

[Dan Kopans @DrDkopans]

Dr.Prasad attacks “proponents” as being too angry to read "classic papers. In fact, screening experts do not simply accept something because it is published. We read everything carefully and challenge faulty analyses. Prasad promulgates scientifically unsupportable material.

[Dan Kopans @DrDkopans]

More than 40 experts in breast cancer (radiologists, surgeons, and oncologists) wrote a Letter to the Editor of the NEJM urging that, because the paper by B&W lacked scientific validity, it should be withdrawn. The NEJM refused to
publish the letter. So much for ethics.

[Dan Kopans @DrDkopans]

Peer review at the NEJM failed. B&W claimed mammography was responsible for massive overdiagnosis of breast cancer! How can you fault mammography when the authors had no data on who had mammograms and which cancers were found by mammography? Basic 1st year medical school stuff!

[Dan Kopans @DrDkopans]

The paper by Drs. Bleyer (why a pediatric oncologist would write on breast cancer screening) and Welch (a PCP who does not provide care for women with breast cancer) (B&W) in the New England Journal of Medicine. Dr. Prasad is clearly in awe of the NEJM ignoring major errors.

[Dan Kopans @DrDkopans]

June 24, 2018@VinayPrasadMD began “Tweetorial2" on mammography screening reviewing a paper that he misunderstood promulgating
misinformation. Ignoring science, and academic discourse, Dr. Prasad has blocked me so Iwill tweet out responses and hope that
they get disseminated

[Dan Kopans @DrDkopans]

The latest paper by Moshina et al Automated Volumetric Analysis.. in Radiology. 2018 Jun 26 confirms what we all know. Sensitivity is reduced in women with dense breasts, but be careful quoting since screening was every two years.