In today’s fast-paced, media-saturated world, messages about mammography are ubiquitous. Breast cancer is sometimes characterized as an imminent threat to life and screening mammography as the way to overcome the resulting sense of vulnerability. Physicians recommend screening mammography, hoping that it will save lives; they also may be concerned about medical malpractice and poor quality performance ratings if they do not encourage screening. But patient fears and physician concerns are not conducive to truly informed shared decision making about a complex choice.