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Optimal Recall Rates Following Mammography
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To the Editor: In their study of breast cancer-screening programs in the United States and the United Kingdom, Dr Smith-Bindman and colleagues1 reported that recall and negative open surgical biopsy rates are twice as high in US settings than in the United Kingdom but that cancer detection rates are similar. The authors concluded that changes in mammogram screening practices should be "targeted to lowering the recall rate."
Their data do not entirely appear to support this conclusion; the authors also reported that the proportion of breast cancers of more than 20 mm on subsequent screening examinations is higher in the United Kingdom than in the United States. This is exactly what would be anticipated if the policy of discouraging recall at the initial screening caused cancers to be missed at the time they were first detectable. The data in the authors' Figure suggest that the rate of cancers of more . . . [Full Text of this Article]
William H. Goodson III, MD
Department of Surgery
California Pacific Medical Center
San Francisco
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