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Dermatopathology: Practical & Conceptual July - September 2003
What ever happened to BANS—and why?
A. Bernard Ackerman, M.D.
Naghmeh Yousefzadeh, M.D.
The history of BANS as conveyed through synopses of publications about it
Addendum 1 (The American Journal of Dermatopathology 1982 Oct;4(5):387–9.)
It was Day
who, in 1982, set forth in the
Annals of Surgery
the concept of BANS, an acronym for those anatomic sites in the skin, which, according to them, signified the worst prognosis for primary cutaneous melanoma, the sites being the upper back, posterior arm, posterior neck, and posterior scalp. Although BANS itself had a very short life, lasting less than four years from the time it was first mentioned in 1982 until it was repudiated in print in 1986 by many of those who had spawned it, the influence of that notion lasted much longer, some of those effects persisting to this day.
We present the story of BANS here in order that lessons, intellectual and ethical, may be learned from it, and with the hope, albeit faint, that the errors in the form of abrogation of principles rudimentary to academic life not be violated or repeated again. The tale of BANS is not an aberration; it is stereotypical of almost everything that came from a single school of thought at several institutions of "higher learning" about the subject of melanoma and of nevi during the last 35 years of the 20th century. That being the case, inevitable it is that in 35 years or so from now an article will appear captioned something like "What ever happened to the dysplastic nevus—and why?" (or perhaps that will happen even before that in
Dermatopathology: Practical & Conceptual).
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