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Massachusetts General Hospital Boston, MA 02114
The Emory Clinic Atlanta, GA 30329
Kirshenbaum et al. [1] make inaccurate claims in the Introduction and Discussion sections of their article "Stereotactic Core Needle Biopsy of Nonpalpable Breast Lesions Using a Conventional Mammography Unit with an Add-On Device." They state that their study is "only the second comprehensive prospective series in which patients underwent stereotactic core needle biopsy on a conventional mammography system with an add-on unit." They also state that only four articles have been published that described using a conventional mammography unit with an add-on stereotactic device. In our study [2] of 180 core biopsies on an upright unit that was published in AJR April 2002, 2 months before their article was received by AJR, we summarized in Table 3 seven studies published in peer-reviewed journals on the subject of upright units. Kirshenbaum et al. cite the study by Caines et al. [3] with 254 core biopsies as the second comprehensive study, but two other published studies were similar in size. The study by Hirst and Davis [4] had 297 core biopsies and the study by Welle et al. [5] had 225 core biopsies. Even our study [2] with 180 core biopsies was considered by reviewers to be "comprehensive," although we acknowledge that our sample was not as large as that of Kirshenbaum et al. Nevertheless, our results were similar and targeting was successful in 98% of cases.
In summary, authors and reviewers should be cautious of statements that make absolute claims, and exhaustive literature searches must be performed before making these types of claims.
References
Advocate Illinois Masonic Medical Center Chicago, IL 22005
Although we appreciate the critical evaluation of our article [1] by Drs. Georgian-Smith and D'Orsi, we were somewhat surprised and would caution them to take their own advice: "Be cautious of statements that make absolute claims." Their assertion that studies by Hirst and Davis [2] and by Welle et al. [3] were comprehensive prospective studies is false. The study by Hirst and Davis evaluated upright core biopsy for microcalcifications only and was by no means comprehensive when compared with our study, which evaluated the biopsy of 201 masses, 217 clusters of microcalcifications, and 75 focal asymmetric densities. The study by Welle et al. is clearly stated to be retrospective.
Finally, we must apologize for not including the study by Georgian-Smith et al. [4] published in the April 2002 issue of the AJR, but those who are familiar with the writing of articles must realize that the literature search is done early in the writing process; in this case, it took place before April 2002.
In summary, critical reviews of claims made in a study should be encouraged, yet the reviewers themselves must be held to a similar standard.
References
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