Comment & Controversy

Reason for status quo in breast-cancer screening? Fear of litigation

In his editorial, Dr. Kaunitz answers his own rhetorical question—“Will I continue to recommend screening mammograms?”—with a fairly equivocal “Yes, unless—until—guidelines change.” I submit that this is exactly how most practicing clinicians regard this issue.

When we send a patient for a mammogram, we know we are not reducing the incidence of invasive cancer. Moreover, for every cancer death prevented, the cost of screening to society is $2.5 million for mammograms alone. Why do we keep sending patients for annual mammograms? Why do we so cavalierly spend this money? Why haven’t guidelines already changed? Why have groups representing practicing physicians been so resistant to new guidelines from the US Preventive Services Task Force? And why does Dr. Kaunitz still recommend screening mammograms?