The Breast-Screening Brawl

Should regular mammography screening be recommended for women in their forties? The question has sparked a controversy that culminated last month at the National Cancer Institute, in a meeting that ended with accusations of fraud and bureaucratic chicanery. Stoking the controversy is sparse and contradictory evidence about whether screening really helps reduce breast cancer mortality in this age group, concern about false positives and unnecessary surgery, and a radical difference in outlook between the radiologists who favor screening and the epidemiologists and public health experts who urge caution.