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To the Editor.—
The article by Kopans et al (1981;246:2819) describing the importance of preoperative mammography in symptomatic women brings a number of important points to our attention. The authors present five reasons for preoperative mammography, and my concern is with the second category.The greatest danger associated with mammography has not been the well-publicized fear of radiation exposure but rather delay in diagnosis of breast cancer because the mammogram was read as normal despite the presence of a mass in the breast. The authors have taken pains to point this out and are obviously aware of the fact that many cancers will not be evident on mammography. However, using the mammogram to define three types of breast masses that do not require biopsy compromises a principle of overriding importance. All dominant breast masses require aspiration or biopsy. Aspiration will deal with many of the lesions in category 2 and
Gump FE. Mammography, Aspiration, and Biopsy. JAMA. 1982;247(24):3313. doi:10.1001/jama.1982.03320490017015