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Letters
October 1, 2008

Nonmammographic Screening for Breast Cancer—Reply

JAMA. 2008;300(13):1515-1517. doi:10.1001/jama.300.13.1516

In Reply: Screening for breast cancer is not straightforward. As Hall1 stated, “Screening programs are inherently inefficient because an entire population is subject to the test, but relatively few individuals benefit, and some are actually harmed.” The low absolute lifetime risk of death from breast cancer Dr Keen notes may, however, be attributable to earlier diagnosis due to screening. Overdiagnosis is an important concern; however, because breast cancer continues to be one of the most frequent causes of cancer death in women, overdiagnosis may not be the most important issue.2,3 Women witness others experiencing or dying from breast cancer, and this personal exposure is the likely cause of fear of breast cancer many women share. For many women, false-positive diagnoses are considered more tolerable than a late diagnosis of cancer.4

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