title: Mammography: an update of the EUSOBI recommendations on information for women.
abstract: 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.
  
  
  CONCLUSIONS
  • 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.
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, Milan, Italy. francesco.sardanelli@unimi.it.|Department of Radiology, Research Hospital (IRCCS) Policlinico San Donato, San Donato Milanese, Milan, Italy. francesco.sardanelli@unimi.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Sardanelli
authors.affiliation: Department of Radiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany.
authors.forename: Eva M
authors.initials: EM
authors.lastname: Fallenberg
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria.
authors.forename: Paola
authors.initials: P
authors.lastname: Clauser
authors.affiliation: Integrative Biomedical Research PhD Program, Università degli Studi di Milano, Milan, Italy.
authors.forename: Rubina M
authors.initials: RM
authors.lastname: Trimboli
authors.affiliation: Department of Radiology, Hospital de la Ribera, Alzira, Valencia, Spain.
authors.forename: Julia
authors.initials: J
authors.lastname: Camps-Herrero
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Helbich
authors.affiliation: Department of Radiology, Duna Medical Center, Budapest, Hungary.
authors.forename: Gabor
authors.initials: G
authors.lastname: Forrai
keywords: Breast cancer; Contrast-enhanced spectral mammography (CESM); Digital breast tomosynthesis (DBT); Mammography; Screening