Selected References From Dr. Goodson’s Participation in Breast Cancer Research

Lumpiness all over a woman’s breasts, called “fibrocystic disease” by some doctors, does not mean that woman has a higher risk of getting breast cancer.
“Any discrete mass, lump, or area of asymmetry must be evaluated completely … [However] clinical examination should not be used to decide that high-risk histopathology [that is, a pre-cancerous change] is likely to be present in an individual woman’s breast.”

William Goodson and others. Clinical Breast Examination and High-Risk Histopathology. The American Journal of Medicine, December 1990.

Finding atypical cells in the fluid from a woman’s breasts indicates an increased risk of developing breast cancer.
“… results of this prospective study offer strong support for our hypothesis that cytologic atypical hyperplasia and hyperplasia in nipple aspirates of breast fluid are associated with an increased risk of breast cancer.”

Margaret Wrensch and others including William Goodson, Abnormal Cytology and Breast Cancer Risk. American Journal of Epidemiology, January 1992.

Taking caffeine out of your diet does not reduce breast lumps and only rarely affects women’s breasts at all.
“… a statistically significant reduction in the severity of [clinically palpable breast findings that] … may be of limited clinical importance … little support for the claim that caffeine-free diets are associated with major, clinically significant improvement in benign breast disease.”

Virginia Ernster and others including William Goodson. Caffeine-free diet and benign breast disease. Surgery, March 1982.

Vitamin E does not make breasts lumps go away.
“… in view of negative results in this prospective, randomized, double-blind trial, routine use of vitamin E for benign breast disease may not be advisable.”

Virginia Ernster, William Goodson, and others. Vitamin E and benign breast “disease.” Surgery, April 1985.

The most common cause of delayed diagnosis of breast cancer is when a physician feels a mass and decides whether or not it is cancer just by touch.
“The leading cause of physician delay in the diagnosis of breast cancer continues to be inappropriate reassurance that a mass is benign without a biopsy. Reducing delay will require less willingness to rely on clinical examination to decide that a mass is benign …”

William Goodson and Dan Moore, Causes of Physician Delay in the Diagnosis of Breast Cancer. Archives of Internal Medicine, June 2002.

Fine Needle Aspiration Biopsy (FNA or FNAB) is a rapid, reliable way to determine if a breast mass is cancer.
“…a reasonable alternative to open biopsy.,.[However] it is never satisfactory to use this test to ignore or chose not to surgically biopsy a lump that is suspicious…”

William Goodson and others. Benign aspiration biopsies of the breast. The American Journal of Surgery, July 1987.

“…[Fine needle aspiration biopsy] when performed by physicians who are well trained in the technique…is a highly accurate, cost-effective diagnostic method that carries minimal morbidity…”

Britt-Marie Ljung and others including William Goodson. Improving diagnostic accuracy of fine-needle aspiration biopsy. Cancer Cytopathology, August 2001

It is not necessary to remove a woman’s breast to treat early breast cancer successfully.
“After 20 years of follow-up, we found no significant difference in overall survival among women who underwent mastectomy and those who underwent lumpectomy with or without radiation therapy.”

Bernard Fisher and others in the NSABP under his leadership. William Goodson was one of the surgeons who recruited patients for this study. New England Journal of Medicine, October 2002.

How fast the cancer is growing is as useful for predicting prognosis as whether cancer has gone to lymph nodes under the arm.
“… high proliferation rate … predicts a higher risk of systemic recurrence and death with significance similar to, and independent of, that of positive node status.”

William Goodson and others. BrdUrd and Ki-67 labeling indices. Breast Cancer Treatment and Research, January 2000

How breast tissue is closed influences how the breast looks after surgery for breast cancer.
“Closure of breast parenchyma [gland tissue] with a radial suture line simultaneously reduces dents and avoids traction that might cause deviation of the nipple.”

William Goodson. Closure of Partial Mastectomy. The American Journal of Surgery, January 2006.

Healing is better after surgery if you are healthy before surgery.
“… postoperative healing is influenced by the preoperative status of the patient in ways not included in the usual consideration…even a brief preoperative illness has a more prolonged influence on postoperative healing than usually anticipated.”

William Goodson and others. Influence of preoperative illness on postoperative healing. Annals of Surgery, March 1987.