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Media feeding frenzy
around breast study

BASED ON REPORTING last year in the Chicago Tribune and The New York Times, many Americans were led to believe that University of Pittsburgh surgeon Bernard Fisher, M.D., was guilty of scientific misconduct. Many women were scared by the coverage, picked up by many other newspapers, which implied Fisher's major research finding--that lumpectomy is as effective as radical mastectomy in treating many women with early breast cancer--may not be valid.

But neither of these impressions is true, according to reporters at the Pittsburgh Post-Gazette. They conducted an in-depth investigation of the charges against Fisher and his work and published their findings late last year (Dec. 26-29).

Fisher has never been found guilty of scientific misconduct, reporters Steve Twedt and Mackenzie Carpenter emphasize. One Canadian surgeon entered some false data into clinical studies. But several reanalyses have confirmed that the false data did not skew the results, and Fisher's multicenter protocols were explicitly designed to minimize the effects of such kind of data mishandling.

In short, lumpectomy, in which the tumor and a small area of surrounding tissue is excised, is in general as effective as radical mastectomy, in which the entire breast is removed. Other studies also have shown this to be so.

The Post-Gazette says in an editorial (Dec. 30) that Fisher was the victim of "nearly hysterical overreaction and political gamesmanship at its worst." It blames the "unconscionable political posturing" of then-powerful congressman and committee chairman John D. Dingell (D-Mich).

"He just blasted away," according to the Post-Gazette's editorial, and "if a few not terribly guilty lives were ruined in the process, that didn't seem to cost Rep. Dingell any sleep."

Fisher was the main victim, the paper notes. The "greater tragedy" may be the "fallout" the episode has had on scientific research and on the public's trust in science.

Still unanswered is this: Why did the press accept Dingell's and the Chicago Tribune's lead in attacking Fisher and his colleagues and their work? Until the Post-Gazette (Fisher's hometown newspaper) published its findings, 10 months after the story broke, no newspaper had critically examined the Tribune's reporting or Dingell's point of view on the case.

Recently, though, Fisher's star has begun to shine again. The research consortium he headed, through which he had directed the breast cancer studies, voted in March--on the anniversary of the Tribune's first, scathing article--to reappoint Fisher, with the title of scientific director.

His colleagues are heartened by the recent developments. The director of the Columbia-Presbyterian Cancer Center, cancer researcher I. Bernard Weinstein, M.D., says, "I've been distressed to see how Dr. Fisher has been treated. But I'm pleased to note that the National Surgical Adjuvant Breast Project has recently appointed him as its scientific director and many of the charges against him have been withdrawn. The basic findings of the study that he led remain sound."

-- David R. Zimmerman

Related links...

Editorial by Eugene Garfield in The Scientist about the Fisher case

"Breast Cancer Updates": Dr. Fisher's comments

Breast cancer information for patients from NY State Education and Research Network's Breast Cancer Information Clearinghouse

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