To the Editor.
—The Editorial by Drs Davis and Love1 contains several points that warrant comment.First, they accurately state that "diagnostic mammographic evaluation is indicated at any age if a woman has a lump." Although accurate, this statement should be accompanied by the proviso that the mammographic evaluation in this circumstance is directed solely to the contralateral breast and to those portions of the ipsilateral breast outside the confines of the palpable mass. Mammograms cannot be used in the evaluation of a palpable breast mass given the "false-normal" rate, as well as the ability to perform needle aspiration or excisional biopsy, and thereby establish histologic diagnosis.Second, while it is also true that no study has yet demonstrated an improvement in the death rate among younger women through the use of mammography, such a study that would meet the standards necessary for statistical validity (ie, comprising the appropriate
Cherry JK. Mammographic Screening. JAMA. 1994;271(23):1827-1828. doi:10.1001/jama.1994.03510470031022