BioCurex, Inc.(fka BOCX)

[TheBocx]

No, is not BS and I asked you to read carefully what I wrote because I anticipated your mistake. You obviously did not followed my advice. So here it is again, with explanatory notes. Let us see if this time you get it.

I wrote: "One might be prompted to say that a combination of tests that leaves out 15% of patients with cancer is unacceptable. And that would be true, only that the actual number is not 15% because that percentage comes from studies using verified cancers (out of 100 women with known cancer, RECAF misses 15). However, the number of cancers in women with a suspicious mammography is not 100%, but only 25% (that is why 75% of biopsies are negative) and the RECAF test would be used on that population, not on a population consisting of 100% cancer patients. Thus, the actual number of cancers missed following a suspicious mammography and a negative RECAF test would be 15% of 25% => 3.75%."

So that there are no more doubts on the topic and you stop calling BS a rationale that requires just a modest understanding of arithmetic: If you start with 100 women with an abnormal mammography, in average, you will get about 25 cancers. Of those 25, RECAF will detect 85% which is 21 women (those get a biopsy for sure). Thus, of the original 100 women with an abnormal mammography, 21 out of the 25 that have cancer are picked by the RECAF test. Only 4 women (3.75%) out of the initial 100 end up having cancer and not being picked up by RECAF. Four, not 15. Get it?

In addition, RECAF will pickup (by a coincidence) 4 false positives (95% specificity on the 75 women without cancer). A suspicious mammography with elevated RECAF results in biopsy. Thus, 4% of women with an abnormal mammography get a biopsy they do not need. That beats the hell out of the 75% that are currently receiving unnecessary biopsies.

In summary:

- Normal mammography => no RECAF test.

- Abnormal mammography with elevated RECAF => biopsy resulting in 4% false positives who did not need the biopsy (as compared to the current 75%).

- Abnormal mammography with low RECAF => no biopsy which results in missing only 4% of cancers in this round (not 15% as you claim). I looked at the percentage of false positives in biopsies:

This study (http://www.ncbi.nlm.nih.gov/pubmed/12673707?ordinalpos=&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.SmartSearch&log$=citationsensor
), was published in 2003 by a group of pathologists in Detroit on core needle biopsies (CNBx) performed on 952 patients.

"RESULTS: The cancers missed on CNBx included 6 ductal carcinomas in situ, 17 invasive ductal carcinomas, 3 invasive lobular carcinomas, and 1 non-Hodgkin lymphoma. The overall false-negative rate was 9.1%. For palpable lesions, ultrasound-guided CNBx had a lower rate of missed cancer (3.6%) compared with CNBx without image guidance (13.3%). The false-negative rate for vacuum assisted CNBx biopsy was 7.6% (3.3% for the 11-gauge needle, 22.2% for the 14-gauge needle; 5.6% for nonpalpable mass lesions, 8.2% for microcalcifications)." (GS: Please let me know if you need any help with those numbers).

Applying the overall false-negative rate of 9.1% to the 25 women with cancer, the biopsies will miss about 2. In other words, abnormal mammography + RECAF misses 4 cancers, abnormal mammography + biopsy misses 2. Not that big a difference statistically speaking and to judge by your own words in the example of the revolver, 1.5% difference in odds is irrelevant. I agree with you and I will extend it to 2%.

In any case, women with a suspicious mammography should be followed up closely and therefore some of these 2% or 4 % false positives will get detected at a later stage.

GS (and Kag), you should be very excited about those numbers because your have argued strongly against the pain, risk, cost (Kag) and inconvenience of biopsies. Here we have a system that can drastically reduce the number of biopsies (from 75% to about 4%) at the cost of leaving undiagnosed cancers inside 4% of patients instead of the 2% the biopsy does. Now, of course, you cannot have it both ways. So what is it going to be? Is it better to reduce the biopsies from 75% to 4% at the cost of an additional 2% false negatives or will you support the notion that we MUST detect all cancers and if all those unnecessary biopsies is the price that needs to be paid so be it! If you are consistent with your previous position, then you will have to acknowledge that RECAF would be great for this application.

Again, please let me know if you need help with the numbers or the rationale, etc and please take your time to read before screaming BS; that is how people learn.