Breast Cancer Screening By Mammography

Leo G. Rigler, MD
JAMA. 1966;196(7):667. doi:10.1001/jama.1966.03100200107042.
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To the Editor:—  The article "Evaluation of Periodic Breast Cancer Screening With Mammography," by Shapiro et al (195:731, 1966), and its accompanying editorial repeat a fallacy which is current in programs of screening for cancer. The introductory abstract reads "Furthermore, the crucial question is whether mortality from breast cancer is lower because of the screening...." The implication is that if the screening does not produce a reduction in mortality, by reason of the earlier detection of a lesion, then it is not worthwhile. I think this is a serious error. Any procedure which permits us to identify small cancers within the population will be of great value even though the known methods of treatment at the time are entirely ineffective.The value lies in the following:

  1. Methods are devised or tested which make possible the detection of hidden cancer. Such procedures give us experience with the method and


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