We are not surprised that Dr Frankl's results are not in concordance with ours. Like those of Dr Wolfe, her data suffer from the bias of referral.1 Our own, much smaller referral patient series (Table 3 in our article) shows a parenchymal pattern distribution similar to hers.The larger proportion of women with N1 and P1 patterns in our screening population reflects the effectiveness of the Kopparberg program in bringing 92.5% of our population younger than 70 years to mammographic evaluation, even in the absence of breast symptoms in most of these women.It seems to us that the relative lack of cancers in the N1 and P1 groups in Dr Frankl's "prevalent" and "incident" series reflects the fact that surgeons often do not refer such patients to preoperative mammography when palpatory findings are unequivocal. The fact that relatively few women with N1 and P1 patterns having
Tabár L, Dean PB. Mammographic Parenchymal Patterns-Reply. JAMA. 1982;248(4):427. doi:10.1001/jama.1982.03330040019015
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