Detection and Treatment of Ductal Carcinoma In Situ of the Breast

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To the Editor. —The article by Dr Ernster and colleagues1raises important questions concerning the diagnosis and treatment of a group of lesions that have been characterized as ductal carcinoma in situ (DCIS). Unfortunately, some of the statements contained in the article could be misconstrued and were misrepresented by the media. The unjustified suggestion that mammography is the cause of the "disfiguring surgery" that results from the diagnosis of DCIS distracted from the clear need to develop a much greater understanding of the significance of DCIS. Mammographic screening is the only method that has been proved to reduce mortality from breast cancer. It is unfortunate the article by Ernster et al could be interpreted as discouraging the use of this screening. I'm sure the authors would agree that the "harm" of the anxiety that may be caused by an abnormal mammogram report or even a breast biopsy is not