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October 17, 1977

One-View Follow-up Mammogram

Author Affiliations

The Medical College of Pennsylvania and Hospital Philadelphia

JAMA. 1977;238(16):1723. doi:10.1001/jama.1977.03280170017012

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To the Editor. —  Cukier et al (237:661, 1977) propose that a single lateral view mammogram is adequate for follow-up screening and that use of this technique would contain costs, lighten the load of reading films, and decrease exposure of patients to ionizing radiation. Their report of 97% "accuracy" from a lateral view alone should be accepted with caution for at least three reasons.First, accuracy, or validity, depends on both good sensitivity and good specificity. Since all the films in this series were from patients with breast cancer, the authors were only able to determine sensitivity (the ability of the test to identify diseased persons) but not specificity (the ability of the test to identify correctly persons without disease).Further, those who read the film were apparently aware that all the patients had breast cancer. This awareness could very well increase the likelihood of finding a cancer.Finally, the