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Mammographic Screening

R. Don Gambrell Jr, MD
JAMA. 1994;271(23):1827. doi:10.1001/jama.1994.03510470031021.
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To the Editor.  —I read the Editorial on mammographic screening with great concern,1 since I had just been heartened the day before with the new 1994 American Cancer Society cancer statistics for 1994.2 For the first time in 60 years, the number of new breast cancer cases are not expected to rise in the United States in 1994: 182000 in 1994, 182 000 in 1993, and 180 000 during 1992. Breast cancer deaths have been level for the third year in a row: 46 000 in 1992,1993, and 1994. Invasive breast cancers have been steadily declining since 1988 because of increased screening mammography.3 Mortality from breast cancer has leveled because of earlier diagnosis.The authors conclude, based on meta-analysis of epidemiologic studies, that screening mammography for women younger than 50 years does not reduce deaths from breast cancer. However, four of the 15 breast cancers (26.7%) diagnosed


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