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.Key Points• 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.

Challenges in mammography education and training today: The perspectives of radiography teachers/mentors and students in five European countries

“…There is no phantom that are like a proper patient to position a mammogram (1,2,154) No phantom like a patient Positioning on the real patient It takes a lot of time to practice and learn how to position the patient (1,3,73) Takes time to learn positioning Time consuming parameters. Theoretical explanations of newer technology and modalities used in mammography were presented as part of their education.…”

“…2 Earlier detection and diagnosis of breast cancer are crucial to improve survival rates and reduce the need for aggressive treatment such as mastectomy. 3 There are several methods of detection. Aside from breast self-examination (BSE) and clinical breast examination (CBE), diagnostic (symptomatic patients) and screening (asymptomatic patients) mammography are the imaging procedures, mostly used to diagnose breast pathologies.…”

Image-guided breast biopsy and localisation: recommendations for information to women and referring physicians by the European Society of Breast Imaging

“…This article is the fifth of a series of recommendations for women's information, all issued by the European Society of Breast Imaging, EUSOBI, the first [7] and the third [8] focusing on mammography, the second on breast magnetic resonance imaging (MRI) [9], and the fourth on breast ultrasound (US) [10]. The current article represents also an update of a previous EUSOBI guideline regarding diagnostic interventional breast procedures, published in 2007 [11].…”

Breast cancer mortality trends in Europe among women in perimenopausal and postmenopausal age (45+)

“…Moreover, there are also evidence that mammography may affect the advanced breast cancer rates and contributes to the lower number of advanced cases [5]. On the other hand, there are estimates that about 1-10% of all diagnosed (mammography) breast cancer cases in European countries could be considered as overdiagnosis [6,7]. Additionally, in 2013 in Switzerland, the Swiss Medical Board (leading Swiss Centre of Competence in Health Technology Assessment) concluded that mammography is not cost effective, and does not result in benefits in quality-adjusted life-years gained [7].…”