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Controversies in Screening Mammography. The utility and effectiveness of screening mammography in diagnosing breast cancer at earlier stages and reducing disease-specific mortality remain controversial especially as to when to start and stop routine mammographic screening, and whether mammograms should be performed annually or biennially in average-risk women. This manuscript will analyze the available moderate and high-quality data to analyze both the benefits (lives saved and life-years saved) and inconveniences/harms (additional views, extra biopsies/overdiagnosis, and overtreatment of ductal carcinoma in situ) of different mammography screening guidelines to assist the practitioner in counseling their patients in clinical practice.