Position paper on screening for breast cancer by the European Society of Breast Imaging (EUSOBI) and 30 national breast radiology bodies from Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Israel, Lithuania, Moldova, The Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Spain, Sweden, Switzerland and Turkey.
EUSOBI and 30 national breast radiology bodies support mammography for population-based screening, demonstrated to reduce breast cancer (BC) mortality and treatment impact. According to the International Agency for Research on Cancer, the reduction in mortality is 40 % for women aged 50-69 years taking up the invitation while the probability of false-positive needle biopsy is <1 % per round and overdiagnosis is only 1-10 % for a 20-year screening. Mortality reduction was also observed for the age groups 40-49 years and 70-74 years, although with "limited evidence". Thus, we firstly recommend biennial screening mammography for average-risk women aged 50-69 years; extension up to 73 or 75 years, biennially, is a second priority, from 40-45 to 49 years, annually, a third priority. Screening with thermography or other optical tools as alternatives to mammography is discouraged. Preference should be given to population screening programmes on a territorial basis, with double reading. Adoption of digital mammography (not film-screen or phosphor-plate computer radiography) is a priority, which also improves sensitivity in dense breasts. Radiologists qualified as screening readers should be involved in programmes. Digital breast tomosynthesis is also set to become "routine mammography" in the screening setting in the next future. Dedicated pathways for high-risk women offering breast MRI according to national or international guidelines and recommendations are encouraged.


CONCLUSIONS
• EUSOBI and 30 national breast radiology bodies support screening mammography. • A first priority is double-reading biennial mammography for women aged 50-69 years. • Extension to 73-75 and from 40-45 to 49 years is also encouraged. • Digital mammography (not film-screen or computer radiography) should be used. • DBT is set to become "routine mammography" in the screening setting in the next future.
Department of Biomedical Sciences for Health, University of Milan, Milan, Italy. francesco.sardanelli@unimi.it.|Department of Radiology, Research Hospital Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Milan, Italy. francesco.sardanelli@unimi.it.
Francesco
http://orcid.org/0000-0001-6545-9427
F
Sardanelli
Department of Radiology, Haukeland University Hospital, Jonas Lies vei 65, 5021, Bergen, Norway.
Hildegunn S
HS
Aase
Department of Radiology, Reina Sofía Hospital, Avda. Menéndez Pidal, s/n 14004, Córdoba, Spain.
Marina
M
Álvarez
Department of Radiology, Karolinska University Hospital, Karolinska vägen, 171 76, Solna, Stockholm, Sweden.
Edward
E
Azavedo
Department of Radiology, Meander Medical Center, Maatweg 3, 3813, Amersfoort, The Netherlands.
Henk J
HJ
Baarslag
Department of Radiology, Gustave-Roussy Institute, 114 Rue Edouard Vaillant, 94800, Villejuif, France.
Corinne
C
Balleyguier
Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna/Vienna General Hospital, Währinger Gürtel 18-20, 1090, Wien, Austria.
Pascal A
PA
Baltzer
Clinic of Radiology, University Clinical Center Sarajevo, Bolnička 25, 71000, Sarajevo, Bosnia and Herzegovina.
Vanesa
V
Beslagic
Clinic of Radiology, Charité, Universitätsmedizin Berlin, 10117, Berlin, Germany.
Ulrich
U
Bick
Diagnostic Imaging Center, Institute of Oncology, Institutski put 4, 21204, Sremska Kamenica, Serbia.
Dragana
D
Bogdanovic-Stojanovic
Radiology Department, National Cancer Institute, Santariskiu 1, Vilnius University, Vilnius, Lithuania.
Ruta
R
Briediene
Department of Diagnostic and Interventional Radiology, University Hospital 'Dubrava', University of Zagreb School of Medicine, Avenija Gojka Šuška 6, 10000, Zagreb, Croatia.
Boris
B
Brkljacic
Department of Radiology, Hospital de la Ribera, Carretera de Corbera, Km. 1, 46600, Alzira, Valencia, Spain.
Julia
J
Camps Herrero
Radiology Unit, Hospices Civils de Lyon, Centre Hospitalo-Universitaire Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre Bénite Cedex, France.
Catherine
C
Colin
Nottingham Breast Institute, Nottingham University Hospitals, Hucknall Rd, Nottingham, NG5 1PB, United Kingdom.
Eleanor
E
Cornford
Department of Radiology, Charles University in Prague, First Faculty of Medicine, U Nemocnice 2, 128 08, Praha 2, Czech Republic.
Jan
J
Danes
Department of Radiology, ImageRive, Rue de Rive 1, 1204, Genève, Switzerland.
Gérard
G
de Geer
Department of Radiology, Acibadem University Maslak Hospital, Buyukdere cd, Maslak, Sariyer, 34457, İstanbul, Turkey.
Gul
G
Esen
Dundee Cancer Centre, Clinical Research Centre, Ninewells Hospital, and Medical School, Tom McDonald Avenue, Dundee, UK.
Andrew
A
Evans
Division of General Radiology, Department of Radiology, Medical University Graz, Auenbruggerplatz 9, 8036, Graz, Austria.
Michael H
MH
Fuchsjaeger
Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Hills Road CB2 0QQ, Cambridge, UK.
Fiona J
FJ
Gilbert
Institute of Radiology, ACC Steyr, Stadtplatz 30, 4400, Steyr, Austria.
Oswald
O
Graf
Department of Radiology, Mater Misericordiae University Hospital/BreastCheck, BreastCheck, 36 Eccles St, Dublin 7, Ireland.
Gormlaith
G
Hargaden
Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna/Vienna General Hospital, Währinger Gürtel 18-20, 1090, Wien, Austria.
Thomas H
TH
Helbich
Referenzzentrum Mammographie Munchen, Sonnenstraße 29, 80331, Munich, Germany.
Sylvia H
SH
Heywang-Köbrunner
Diagnostic Department of Radiology, Tokuda Hospital Sofia, 1407, Sofia, 51B N Vaptsarov Blvd., Bulgaria.
Valentin
V
Ivanov
Department of Radiology, Landspitali University Hospital, 108, Reykjavik, Iceland.
Ásbjörn
Á
Jónsson
University Hospital of Aachen, Rheinisch-Westfälische Technische Hochschule, Pauwelsstraße 30, 52074, Aachen, Germany.
Christiane K
CK
Kuhl
Radiotherapy I, The Oncology Institute 'Prof. Dr. Ion Chiricuta', Cluj-Napoca, 34-36 Republicii Street, RO-400015, Romania.
Eugenia C
EC
Lisencu
Department of Radiology Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow Branch, Cracow, Poland.
Elzbieta
E
Luczynska
Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
Ritse M
RM
Mann
Department of Radiology/Breast Imaging, Instituto Português de Oncologia de Lisboa, Rua Professor Lima Basto, 1099-023, Lisboa, Portugal.
Jose C
JC
Marques
U.O. Radiodiagnostica, Candiolo Cancer Institute - FPO, IRCCS, Str. Prov. 142, km 3.95, 10060, Candiolo, Turin, Italy.
Laura
L
Martincich
Genitourinary Radiology, Ghent University Hospital, De Pintelaan 185, 9000, Gent, Belgium.
Margarete
M
Mortier
Klinik für Radiologie, Neuroradiologie & Nuklearmedizin, Klinikum Frankfurt Hoechst, Frankfurt, Germany.
Markus
M
Müller-Schimpfle
Diagnoscan, SZTE Radiológiai Klinika, Szeged, Semmelweis u. 6, 6725, Szeged, Hungary.
Katalin
K
Ormandi
Breast Imaging Unit, Scientific Institute (IRCCS) Ospedale San Raffaele, Via Olgettina, 60, 20132, Milan, Italy.
Pietro
P
Panizza
Department of Radiological, Oncological and Pathological Sciences, Sapienza University, Viale Regina Elena, 324, 00161, Rome, Italy.
Federica
F
Pediconi
Department of Imaging, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
Ruud M
RM
Pijnappel
Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna/Vienna General Hospital, Währinger Gürtel 18-20, 1090, Wien, Austria.
Katja
K
Pinker
Department of Diagnostic Radiology, Oulu University Hospital, Kajaanintie 50, 90220, Oulu, Finland.
Tarja
T
Rissanen
Department of Radiology and Medical Imaging, State University of Medicine and Pharmacy 'Nicolae Testemitanu', bul. St.cel Mare 165, Chisinau, MD 2012, Moldova.
Natalia
N
Rotaru
Italian Group for Mammographic Screening (GISMa); Senology Unit, Local Health Authority, Bologna, Italy.
Gianni
G
Saguatti
Marlene Greenebaum Diagnostic Breast Center, Department of Radiology, Hadassah Hebrew University Hospital, Hadassah Ein Kerem Medical Center, 91120, Jerusalem, Israel.
Tamar
T
Sella
Clinic of Radiology, Alexander Dubček University of Trenčín in Trenčín, Faculty of Healthcare, Študentská 2, 911 50, Trenčín, Slovakia.
Jana
J
Slobodníková
Radiology Centre, North Estonia Medical Centre, 19 Sütiste Street, 13419, Tallinn, Estonia.
Maret
M
Talk
Department of Radiology, Hôpital Lapeyronie, 371 Av. du Doyen Gaston Giraud, 34295, Montpellier, France.
Patrice
P
Taourel
Department of Radiology, Research Hospital Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Milan, Italy.
Rubina M
RM
Trimboli
Department of Radiology, Rigshospitalet Blegdamsvej and Glostrup, Mammography Screening Programme in Capital Region, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Ilse
I
Vejborg
Diagnostic Mammography Center, Kifisias 362, Chalandri, 15233, Athens, Greece.
Athina
A
Vourtsis
Duna Medical Center, Lechner Ödön fasor 7, 1095, Budapest, Hungary.
Gabor
G
Forrai
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000517:prevention & control; D055088:Early Detection of Cancer / Q000379:methods*; D005060:Europe; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008403:Mass Screening / Q000458:organization & administration*; D008875:Middle Aged; D008877:Middle East
Breast cancer; Digital breast tomosynthesis (DBT); Digital mammography; Population-based screening; Recall rate