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May 15, 1996

A 47-Year-Old Woman With Ductal Carcinoma In Situ of the Breast

Author Affiliations

Boston University School of Medicine Boston, Mass

JAMA. 1996;275(19):1477. doi:10.1001/jama.1996.03530430021020

To the Editor.  —The Clinical Crossroads article by Dr Morrow1 was clinically informative regarding treatment options and outcomes for breast ductal carcinoma in situ (DCIS). It would have been useful if the discussion also included the mammographic evaluation that led to the biopsy. Primary care physicians who routinely advise their patients to have screening mammography not infrequently receive a reading with a recommendation for a 6-month follow-up examination. Mrs Y may have saved herself from such follow-up by seeking a second opinion—is it appropriate to wait 6 months for follow-up?The American College of Radiology has suggested a standardized nomenclature for mammography and, in effect, has categorized the level of suspicion for malignancy.2 Why did the second group of physicians described in the article recommend biopsy when the original radiologist recommended a 6-month reexamination? Indeed, for indeterminant or probably benign abnormalities, the latter approach is expected to yield