[Moscow screening: breast cancer screening with mammography as a method of improving early stage cancer detection]

A list of organizational, management, and clinical steps that are crucial for creating an effective breast cancer screening program as part of the state medical benefits scheme in Moscow is presented. We identified key performance indicators for each stage of the screening program. Performance of radiologists and radiology technicians was evaluated, including assessing the accuracy of both single and double reading of mammograms. We streamlined an efficient system for patient routing between the stages of the screening program and developed methodological materials for patients and medical specialists. A shortened structured protocol for mammography interpretation, including second reading, was created in compliance with terms of Moscow Compulsory Medical Insurance Fund. We conceived a framework of educational activities to assess and improve skills and knowledge of radiologists and other specialists participating in the screening.