The burgeoning literature regarding screening mammography at times seems to ignore, and yet, by its volume, indirectly acknowledges, the complexity of this activity. Consider briefly the sequence of behaviors healthy women and their physicians may follow. A woman initiates a health care encounter with (possibly only partially or unconsciously recognized) or without signs of breast disease. The physician may perform a breast examination and may take a spectrum of actions concerning mammographyfrom limited discussion to promptly arranging for the study. At a site other than the physician's office, at another time, mammograms are performed. An immediate (possibly) and final written report of findings are sent to the ordering physician by the radiologist. The physician acts on the findings, including informing the woman. The woman acts on the reported findings. When one considers the myriad of factors that might influence the repeated regular and successful completion of this abbreviated cascade of
Love RR, Davis JE. Screening Mammography in Clinical Practice: A Complex Activity. Arch Intern Med. 1991;151(1):19–21. doi:10.1001/archinte.1991.00400010043002
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