[Development of the incidence and mortality of breast cancer]

In Germany, breast cancer is still the most frequent cancer site with approximately 45.000 incident cases and 18.000 deaths annually. After a continuous increase of mortality for decades and a short period of stagnation, a decline can be observed since a couple of years. However, this turnaround has not been preceded by an analogous evolution of breast cancer incidence. A similar development can also be observed in other countries. The conditions under which this changing trend has occurred indicate that it might have been caused mainly by better treatment and only to a low extent by altered prevalence of risk factors or the implementation of screening programmes. Due to the expected latency, an influence of organized screening on mortality can be expected only at the end of the 1990s, i.e., at the end of the period for which data is available or later. In the discussion about implementation of quality-controlled screening in Germany, it should be kept in mind that the quality of the entire programme--starting with screening and ending with therapy--will decide to what extent breast cancer mortality can be reduced.