background: Evidence from breast screening programs demonstrates the value of mammography in the detection of asymptomatic breast cancer.methods: This study prospectively assessed the role of mammography in the management of 585 patients presenting to a breast clinic, over a 1-year period, with symptomatic breast disease and without clinical or cytological evidence of malignancy.results: Eighteen (3%) of these patients had breast cancer. Eight patients presenting with nonspecific nodularity had carcinoma. All patients had relatively early disease.conclusions: This study suggests that patients with symptomatic disease presenting to a breast clinic represent a group at higher risk of malignancy than screened asymptomatic patients, and that symptomatic women over 40 years of age should have bilateral mammography before being discharged from the breast clinic.