EMAS position statement: Individualized breast cancer screening versus population-based mammography screening programmes

• Women may be divided into ‘low to moderate’ and ‘high’ risk for breast cancer categories.
• An individualized approach towards screening should be instigated.
• In the ‘low to moderate’ risk category further mammography screening should be discussed.
• In the ‘low to moderate’ risk category there is no agreement about the screening interval.
• In high risk women yearly digital mammography, ultrasound and clinical examination is warranted.

IntroductionBreast cancer is the most prevalent cancer in women, with slightly more than ten percent developing the disease in Western countries. Mammography screening is a well established method to detect breast cancer.AimsThe aim of the position statement is to review critically the advantages and shortcomings of population based mammography screening.Materials and methodsLiterature review and consensus of expert opinion.Results and conclusionMammography screening programmes vary worldwide. Thus there are differences in the age at which screening is started and stopped and in the screening interval. Furthermore differences in screening quality (such as equipment, technique, resolution, single or double reading, recall rates) result in a sensitivity varying from 70% to 94% between studies. Reporting results of screening is subject to different types of bias such as overdiagnosis. Thus because of the limitations of population-based mammography screening programmes an algorithm for individualized screening is proposed.