[Mammography screening. Concept, quality assurance and interdisciplinary cooperation]

Area of Science:

• Oncology
• Radiology
• Pathology

Background:

• The German National Mammography Screening Program, established in 2005/2006, adheres to European guidelines.
• It employs over 30 quality control parameters to ensure program effectiveness.

Purpose of the Study:

• To reduce breast cancer mortality rates.
• To facilitate early diagnosis and treatment of small breast cancers.

Main Methods:

• Mammograms are interpreted by two independent readers.
• Histological assessment, predominantly via core needle biopsy (CNB) or stereotactic vacuum-assisted biopsy (VABB), is performed for approximately 2% of examinations.
• Electronic documentation tracks each step of the screening process.

Main Results:

• Approximately 45% of screen-detected breast cancers are in-situ or less than 10 mm.
• Needle biopsies diagnose B3 or B4 lesions in 17% of cases, requiring specialized pathological and interdisciplinary input.
• Open diagnostic biopsies are used in less than 10% of histological assessments.

Conclusions:

• Effective screening relies on rigorous quality control and interdisciplinary collaboration.
• Addressing challenges like sampling errors and partial volume effects is crucial for optimizing diagnostic and therapeutic decisions.
• The program successfully detects early-stage breast cancers, necessitating careful management of complex biopsy findings.