To the Editor.
—The study by Dr Kerlikowske and colleagues1 on the effect of age, breast density, and family history on the sensitivity of first screening mammography is an important contribution to the debate on the age at which screening for breast cancer should start. The balanced discussion of their results highlighting the problems involved with screening women aged 40 to 49 years is particularly valuable. They draw attention to the questionable value of the early diagnosis of ductal carcinoma in situ (DCIS) when it may not progress to invasive disease and to the fact that the effectiveness for reducing mortality from breast cancer has yet to be proven in this age band. Unfortunately, the main findings of this study have been interpreted by a popular medical newspaper, Arzte Zeitung, as further evidence for recommending mammography for women aged 40 to 49 years on an annual basis2 without
Werneke U. Screening Mammography and Risk of Breast Cancer. JAMA. 1996;276(18):1470. doi:10.1001/jama.1996.03540180026018