Preface: controversies in breast cancer

On 3–4 September 2007 a faculty of world experts on breast cancer gathered in the Royal College of Physicians, Edinburgh, not to present their latest results, but to debate a series of controversial issues relating to breast cancer with an invited audience.

The intention was to highlight the points that made the topics controversial, with the initial objective being to clarify rather than resolve the issues. In this way additional thought, perspective and understanding would be forthcoming and ultimately resolution might be more likely. This volume represents a summary of the proceedings as formulated by each of the presenters.

Before delving into the communications, the reader should appreciate the nature of each session and the brief given to the faculty. Topics and faculty were selected by the chairman, and each chairperson has been invited to provide a foreword for their sessions. It is also important to have a perception of the mechanism by which the controversies were tackled. Thus, in certain cases, most notably in the presentations on psychosocial aspects of breast cancer, one facet of the topic was put forward by a proposer and a different, often opposing, view by another member of the faculty. To achieve a balance, it may therefore be necessary to integrate several individual short communications. Furthermore, in the sessions on challenging established dogma, the faculty members were asked to be a devil's advocate and to be provocative in their presentations, providing that they could reference substantiating results. It should therefore not be assumed that the perspectives are necessarily firmly held views of the authors.

The short communications are aimed at provoking thought in the hope of progressing science and improving practice. The volume should not be regarded as a standard text reflecting routine proceedings; instead, it is intended to be a stimulating text, challenging the reader to question perceived wisdom.