CAR Practice Guidelines on Breast Imaging and Interventions: Mammography and Digital Breast Tomosynthesis

This guideline presents Part I of the Canadian Association of Radiologists (CAR) Practice Guidelines on Breast Imaging and Intervention and focuses on mammography and digital breast tomosynthesis (DBT). Developed by the CAR Breast Imaging Working Group, this guideline provides updated, evidence-based recommendations for screening and diagnostic mammography, reflecting advances in digital imaging, tomosynthesis, artificial intelligence, and quality assurance since the previous consolidated guidelines published in 2016. Key areas addressed include clinical indications, equipment and technical standards, radiation dose considerations, reporting using BI-RADS^®, personnel qualifications, and performance benchmarks. This guideline emphasizes the central role of mammography and DBT in breast cancer detection while supporting the integration of emerging technologies to improve diagnostic accuracy and efficiency. It is intended to be used in conjunction with the other 4 components of the CAR Breast Practice Guidelines on Breast Imaging and Intervention and alongside the CAR Breast Disease Imaging Referral Guidelines. While outlining best practices and minimum expectations, this guideline acknowledges that practice variation may be appropriate based on patient factors and available resources, with ultimate responsibility for clinical decision-making resting with the supervising radiologist.