To the editor: The personalization and tailoring of medical care based on discoveries is an important advancement that has led to more targeted therapies. However, this concept should not be indiscriminately applied across the board to all aspects of medicine when complete scientific understanding of a disease process or risk factors are not yet clear. (“More isn’t better when it comes to mammograms,” editorial, Oct. 21)
A case in point is the attempt to personalize screening mammography by stratifying women based on their apparent risk of developing breast cancer.
Clearly, women at high risk for developing breast cancer should be screened annually, but the flip-side assumption that women with no identifiable risk factors should be screened less frequently is incorrect.
Three-fourths of women diagnosed with breast cancer have no identifiable risk factor. Women who choose to be screened less frequently based on the absence of known risk factors may miss their opportunity to have breast cancer diagnosed at an early, more treatable stage.
Until we have a better understanding of all of the causes of breast cancer, we need to continue to screen average-risk women annually with mammography beginning at age 40. This translates into a 30% to 40% decrease in breast cancer mortality and saves the most lives.
Anne C. Hoyt, MD, Los Angeles
The writer is a professor of radiology and the medical director of breast imaging at UCLA.