My patients’ fear of breast cancer is palpable. I see them fret over whether or not to have a mammogram, worry about false positive abnormalities, and struggle to pay for diagnostic evaluations for which they are not reimbursed. This collateral damage of screening is obvious to clinicians. However, increasing evidence now indicates a less obvious outcome of cancer screening — overdiagnosis of diseases that would never cause symptoms or death. The presence and effects of overdiagnosis are less tangible, buried in population statistics rather than patient encounters. Overdiagnosis of breast cancer has been suggested on the basis of multiple studies . . .