THE IMPACT of mammography on the earlier detection, diagnosis, and management of breast cancer has been dramatic and undeniably positive. The American College of Radiology and the American Cancer Society have been unequivocal in outlining recommendations for the use of mammography as both a screening and a diagnostic tool.1,2 By strongly recommending the use of mammography in evaluating breast symptoms, they have unwittingly created the impression that the absence of radiographic evidence of a malignant condition effectively excludes the presence of breast cancer. Despite the publication of false-negative rates and disclaimers that some radiologists have included in their mammographic reports stating that the lack of radiographic evidence of a malignant condition should not delay further investigation of a palpable mass, many physicians, and most patients, except those who have learned from experience, are surprised to discover that not all cancers are radiographically evident. Has mammography been oversold?
Newsome JF, McLelland R. A Word of Caution Concerning Mammography. JAMA. 1986;255(4):528. doi:10.1001/jama.1986.03370040102032