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June 13, 1986


JAMA. 1986;255(22):3118. doi:10.1001/jama.1986.03370220080025

To the Editor.—  The recent COMMENTARY in JAMA1 may have inadvertently left many readers with a false and adverse impression of mammography. The article states that "by strongly recommending the use of mammography in evaluating breast symptoms, they have unwittingly created the impression that the absence of radiologic evidence of a malignant condition effectively excludes the presence of breast cancer. Many physicians... are surprised to discover that not all cancers are radiographically evident. Has mammography been oversold?" I believe the authors sell their colleagues short. Surely any physician or other scientist knows that no examination is 100% accurate and that false-negative findings from mammograms occur, particularly in the published series in which all the patients have palpable masses. Fortunately, mammographers are aware of, and should state in their reports, the suitability of the breasts to mammographic interpretation.I am also disturbed by the statement that "false-negative rates... make mammography an