To the Editor: The Editorial by Dr Kuhl1 advocated breast MRI and other additional screening for breast cancer. However, for younger women there is an important issue of whether the average absolute benefit of any breast cancer screening is worth the harms and the opportunity costs.
Kuhl dismissed the first major harm inherent in screening healthy women: false-positive evaluation and biopsy-related anxiety. Screening advocates should help quantify this psychological distress and the opportunity costs for use in cost-effectiveness analyses.
Keen JD. Nonmammographic Screening for Breast Cancer. JAMA. 2008;300(13):1515-1517. doi:10.1001/jama.300.13.1515-b