A doctor-dominated federal advisory group has said doctors should not be required to tell some women in a federal breast cancer project that the physicians removed their breasts needlessly.
But federal health officials said yesterday they will ignore this advice and make sure any woman who had a breast removed in error is notified.
The committee recommendation was called an "outrage" yesterday by Dr. Sidney Wolfe, director of the Public Citizen Health Research Group. Wolfe also said the National Cancer Institute and the American Cancer Society are partly to blame for any unneeded surgery because of "irresponsible lack of surveillance."
Wolfe also reported that one woman in a detection program at Georgetown University had a breast removed unnecessarily. He said there were no errors at some centers but there were eight at a Columbia, Mo., center and seven each at centers in Atlanta and Cincinnati.
In reply, a key cancer institute adviser, Dr. Oliver Beahrs of the Mayo Clinic, said he has "full confidence" that doctors would be honest with their patients. But he said further study will show that "very few" breasts were removed because of misdiagnosis.
The events were the latest development in a $54 million NCI/ACS program that has given 200,000 women annual breast X rays and other tests to seek cancer, and has found 2,500 cancers.
However, X rays can cause cancer in some cases. So in mid-September a study group headed by Beahrs recommended that annual X rays be limited to women over 50, women 35 to 49 who have had a breast cancer already, and women 40 to 49 who have had mothers or sisters with breast cancer.
As a result of a study of slides of breast tissue, the Beahrs group discovered that 53 women apparently had breasts removed for what review-group pathologists considered non-cancerous conditions.
A National Institutes of Health panel chaired by Dr. Samuel Thier of Yale said women who had breast removed because of faulty diagnosis should be told.
But on Oct. 12 - during a cancer control advisory committee meeting headed by Dr. William Shingleton of Duke University - Beahrs successfully moved a recommendation that the women's doctors need only "consider" discussing any new findings with their patients.
Dr. Diane Fink, NCI's cancer control director, said yesterday that NIH and NCI officials have firmly decided that the women should be notified, desirably by their own doctors, but by other means if necessary.
The only possible exception, she said, might be in the case of a mentally disturbed woman, for example, where such bad news might be disastrous.