[Second reading in breast cancer screening program: State of knowledge and future]

Area of Science:

• Oncology
• Radiology
• Public Health

Background:

• Second reading is integral to organized breast cancer screening programs.
• Its primary goals include image quality control and identifying cancers missed by the first reader.
• Currently, 6% of screening-detected cancers in France are identified through second reading, predominantly using film screen methods.

Purpose of the Study:

• To analyze the current state and future needs of second reading in breast cancer screening.
• To propose improvements for this public health program in light of technological advancements and digitalization.

Main Methods:

• Review of organizational structures and results of second reading in France and internationally.
• Analysis of current and anticipated shortcomings in the existing process.
• Collection of propositions from professionals involved in breast cancer screening.

Main Results:

• The current second reading process, largely reliant on film screen, faces limitations.
• Technological evolution, including Digital Breast Tomosynthesis and Artificial Intelligence, presents opportunities for enhancement.
• Professional input highlights the need for modernization to improve cancer detection rates.

Conclusions:

• The second reading process in breast cancer screening requires significant evolution to incorporate new technologies.
• Digitalization and advancements like AI and DBT can enhance the effectiveness of second reading.
• Implementing proposed improvements is essential for optimizing this public health initiative and improving patient outcomes.