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February 15, 1995

Do Specialists Screen for Breast Cancer?-Reply

Author Affiliations

National Cancer Institute Bethesda, Md

JAMA. 1995;273(7):519. doi:10.1001/jama.1995.03520310011005

In Reply.  —National data support the conclusion of Drs Stoffer and Szpunar that specialists treating older women need to make an effort to ensure their patients are being adequately screened for breast cancer since older women are at greatest risk of breast cancer and are least likely to be screened.Corroboration that specialists do not recommend many mammograms can be found in the National Ambulatory Medical Care Survey (NAMCS),1 which shows, in 1991 for example, mammograms ordered or provided by 13 physician specialties. Eighty-seven percent of all mammograms were recommended by primary care (27%) and obstetrics/gynecology (40%). Patients seen by specialists may have had mammograms ordered by their primary care physicians, so the number of patients seen by specialists who underwent mammography would be higher than is apparent from these data.Viewing these NAMCS data another way, mammograms are 1.7% of all the services ordered or provided by physicians

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