We found the Research Letter by Radhakrishnan et al1 rather dispiriting. It suggests that a large proportion of primary care physicians recommend screening mammography for women who are more likely to experience harms than benefits from the examination. Owing to the greater chance of harm, neither the American Cancer Society nor the US Preventive Services Task Force (USPSTF) recommend routine screening mammography for women ages 40 to 44 years. Despite this, 81% of the primary care physicians surveyed in this study reported that they recommend mammography to women in this age range.