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Article |

Mammography Before Age 50 Years?

John C. Bailar III, MD, PhD
JAMA. 1988;259(10):1548-1549. doi:10.1001/jama.1988.03720100066041.
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Considerable agreement exists about mammography. Virtually all experts conclude that an asymptomatic woman who is at least 50 years old will benefit from regular breast cancer screening by a combination of mammography and careful physical examination. Most agree, also, that women who have genuine signs or symptoms suggestive of a malignant lesion are candidates for mammography, regardless of their age, when it is clear that the examination is needed to determine the next steps in the diagnostic studies. This use of mammography, as an aid to diagnosis rather than for screening, will generally be appropriate when the examination will assist in determining whether, where, and how to perform a biopsy.

While agreement exists for this population of women, for those younger than 40 years of age, the arguments for a "baseline" examination are incomplete and unconvincing. No good evidence exists showing that the availability of baseline films affects the later


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