This article summarises the information to be offered to women about mammography. After a delineation of the aim of early diagnosis of breast cancer, the difference between screening mammography and diagnostic mammography is explained. The need to bring images and reports from the previous mammogram (and from other recent breast imaging examinations) is highlighted. Mammography technique and procedure are described with particular attention to discomfort and pain experienced by a small number of women who undergo the test. Information is given on the recall during a screening programme and on the request for further work-up after a diagnostic mammography. The logic of the mammography report and of classification systems such as R1-R5 and BI-RADS is illustrated, and brief but clear information is given about the diagnostic performance of the test, with particular reference to interval cancers, i.e., those cancers that are missed at screening mammography. Moreover, the breast cancer risk due to radiation exposure from mammography is compared to the reduction in mortality obtained with the test, and the concept of overdiagnosis is presented with a reliable estimation of its extent. Information about new mammographic technologies (tomosynthesis and contrast-enhanced spectral mammography) is also given. Finally, frequently asked questions are answered.
• Direct digital mammography should be preferred to film-screen or phosphor plates.
• Screening (in asymptomatic women) should be distinguished from diagnosis (in symptomatic women).
• A breast symptom has to be considered even after a negative mammogram.
• Digital breast tomosynthesis increases cancer detection and decreases the recall rate.
• Contrast-enhanced spectral mammography can help in cancer detection and lesion characterisation.
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Perry N, Broeders M, de Wolf C et al. (2006) European guidelines for quality assurance in breast cancer screening and diagnosis. Fourth Edition. Available at: http://www.euref.org/european-guidelines. Accessed on Sept 10, 2016
American College of Radiology (ACR) Breast Imaging Reporting and Data System Atlas (BI-RADS Atlas). Reston, Va, USA: American College of Radiology; 2013. At: http://www.acr.org/Quality-Safety/Resources/BIRADS. Accessed on 9 Sept 2016.
Skaane P, Bandos AI, Gullien R et al (2013) Comparison of digital mammography alone and digital mammography plus tomosynthesis in a population-based screening program. Radiology 267:47–56
Lobbes MBI, Lalji U, Houwers J et al (2014) Contrast-enhanced spectral mammography in patients referred from the breast cancer screening programme. Eur Radiol 24:1668–1676 PubMed
Jeukens CRLPN, Lalji UC, Meijer E et al (2014) Radiation exposure of contrast-enhanced spectral mammography compared with full-field digital mammography. Invest Radiol 49:659–665
Tennant SL, James JJ, Cornford EJ et al (2016) Contrast-enhanced spectral mammography improves diagnostic accuracy in the symptomatic setting. Clin Radiol 71:1148–1155
Oeffinger KC, Fontham ET, Etzioni R et al (2015) Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society. JAMA 314:1599–1614
- Mammography: an update of the EUSOBI recommendations on information for women
Eva M. Fallenberg
Rubina M. Trimboli
Thomas H. Helbich
for the European Society of Breast Imaging (EUSOBI), with language review by Europa Donna–The European Breast Cancer Coalition
- Springer Berlin Heidelberg
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