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Do specialists screen for breast cancer?

To the Editor. —We were very interested in the JAMA Medical News & Perspectives 1 article on mammography and the comments of Nancy Breen, PhD. She states that "[o]ne of the problems is that the women who need screening most—older women are at higher risk for breast cancer—often are using a cardiologist or other physician who is treating their main disease as their source of primary care. But those physicians do not think of themselves as primary care doctors, so they do not recommend or ask if the woman has had a mammogram this year." However, the article cited by Breen and Kessler 2 provides no supporting data for this view. One of us (S.S.S.) is a thyroidologist who had not previously screened patients with mammography. In an initial study, we compared the mammogram results obtained during a 6-month period of 75 patients with thyroid disease from the subspecialist's thyroid practice