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In Reply

Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL

We agree with Dr Atkin's description of the conclusions from the report of the International Workshop on Screening for Breast Cancer. ¹ The statement reporting a mortality benefit described for women older than age 40 years is supported by a meta-analysis that included several randomized trials and specifically evaluated benefits for women age 40 to 49 years.² We regret that this additional reference was not attached to this statement. We agree with Dr Atkins that there remains uncertainty regarding long-term radiation exposure from mammography, particularly in high-risk women who begin screening earlier than age 40 years. As we hoped to convey, we feel that alternative imaging modalities, such as breast magnetic resonance imaging, which do not involve radiation exposure may ultimately replace mammography in individualized programs for breast cancer prevention.³

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

The authors indicated no potential conflicts of interest.

REFERENCES

1. Fletcher SW, Vlack W, Harris R, et al: Report of the International Workshop on Screening for Breast Cancer. J Natl Cancer Inst 85:1644-1656, 1993[Abstract/Free Full Text]

2. Hendrick RE, Smith RA, Rutledge JH III, et al: Benefit of screening mammography in women aged 40-49: A new meta-analysis of randomized controlled trials. J Natl Cancer Inst Monogr 22:87-92, 1997[Abstract/Free Full Text]

3. Bradbury A, Olopade OI: The case for individualized screening recommendations for breast cancer. J Clin Oncol 24:3328-3329, 2006[Free Full Text]

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