To the Editor: In their study of the use of ultrasound and mammography in breast cancer detection in a high-risk population, Dr Berg and colleagues1 stated that trials to look at actual improvement in survival “are costly . . . and . . . not practical under all contexts.” In contrast, I believe that it may be more costly not to do those trials. In their absence, the costs of ultrasound use and its attendant false positives will add expense to the health care system without sufficient evidence of net benefit.
Magee BD. Ultrasound and Mammography for Breast Cancer Screening. JAMA. 2008;300(13):1514-1515. doi:10.1001/jama.300.13.1514-a