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April 19, 1985

Early Detection of Breast Cancer

Author Affiliations

University of California, San Francisco School of Medicine

JAMA. 1985;253(15):2195. doi:10.1001/jama.1985.03350390036017

To the Editor.—  The recent report by the Council on Scientific Affairs1 is a succinct review of a complicated subject. The recommendations on mammography agree with recommendations from the American Cancer Society and the American College of Radiology. However, the costs of these recommendations were not discussed. The report states, "If every woman older than 40 years under-went annual mammography, 7,500 cancer deaths could be prevented each year." In the San Francisco Bay Area, the charges for bilateral xeroradiographic mammography are at least $150. There are at least 40 million American women older than 40 years, and if each were screened yearly, the charge for screening mammography would be $6 billion (or somewhat less if there were some economy of scale)! This translates into a cost of approximately $800,000 per life saved. This only considers mammography costs, and does not include office visits, the costs of biopsies on those who