We at the US National Breast Cancer Coalition (NBCC) disagree with your assessment of our 2020 goal of knowing how to prevent breast cancer and its associated deaths (Nature 491, 637; 2012). Working towards that goal will not erode public trust, as you suggest.

Nearly 500,000 women worldwide died of breast cancer last year, despite billions of dollars being invested in research. Many scientists believe that current funding systems favour 'safe' research over bold new ideas. As a result, progress is incremental, leading to slightly better treatments, surgical interventions and radiation regimes. These may provide some benefit, but bring no end to the disease itself.

Scientists and the NBCC need to work together to reorder priorities and change the conversation and culture of science. Trust is not lost when advocates call for a deadline and provide a blueprint for meeting it. But it is eroded when scientific infrastructure is unaccountable to the people intended to benefit from its output; when there is not enough emphasis on translating research discoveries to the clinic; and when published results cannot be replicated and marginal advances are over-hyped. Meanwhile, more and more people lose their lives.

Take a calculated risk with us. Let's reach for what might in fact be possible.