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Mammography Screening in Women Under Age 50 Years

Laszlo Tabar, MD; Nicholas E. Day, PhD; Peter B. Dean, MD
JAMA. 1988;260(4):473. doi:10.1001/jama.1988.03410040045009.
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To the Editor.—  We read with interest the article by Eddy et al1 about the value of mammographic screening for women aged 40 to 49 years. We agree that current data permit only an estimate of the quantitative benefits (ie, reduction in breast cancer mortality), with a wide range of uncertainty in this age group, but we feel that the problem of determining the usefulness of mammography is compounded by the continual improvements in this technique. Mammography as carried out in the Health Insurance Plan study, on which Eddy et al base most of their conclusions, has little relevance to present-day practice and should not form the basis of future policy. Compared with the Health Insurance Plan study, the two-county Swedish study, based essentially on single-view mammography as practiced in the late 1970s, achieved both a higher sensitivity of mammography and approximately twice the lead time.2,3 The earlier


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