Systematic and quality-assured early diagnosis of sporadic breast cancer : Update on screening effects and scientific studies

• Published in: Radiologe 2021-02, Vol.61 (2), p.126-136
• Main Authors: Heindel, Walter, Bock, Karin, Hecht, Gerold, Heywang-Köbrunner, Sylvia, Kääb-Sanyal, Vanessa, Siegmann-Luz, Katja, Weigel, Stefanie
• Format: Article
• Language: ger
• Subjects: Breast Neoplasms - diagnostic imaging; Early Detection of Cancer; Female; Germany; Humans; Mammography; Program Evaluation; Quality Assurance, Health Care
• ISSN: 1432-2102
• DOI: 10.1007/s00117-020-00803-1

A quality-assured mammography screening programme has been available since 2009, nationwide, to all women in Germany between the ages of 50 and 69. The programme is based on the European Guidelines. In this review article the authors summarize the current status of scientific assessments of this national early detection programme for breast cancer and provide an outlook regarding ongoing studies on effectiveness tests and further development. We expect a decline in mortality rates relating to breast cancer as a result of successfully bringing diagnoses forward and a decrease in advanced breast cancer after a repeated screening. The extent will be shown in the current ZEBra study on mortality evaluation. Potential for a further increase in the effectiveness of the systematic early detection of breast cancer can be identified in four areas: (1) More women should take advantage of the early detection opportunities offered by the medical insurance funds; so far, on average, only about 50% of the women between 50 and 69 who are entitled to a screening examination actually take part in the programme. (2) Entitlement to take part in the programme should be extended to women over 70. (3) The further development of digital mammography towards digital breast tomosynthesis promises to reduce the number of false positive recalls while at the same time increasing sensitivity. (4) There should be scientific studies relating to an extension of screening strategies for the small number of women in the entitlement range who have extremly dense breasts.