For example , mammography screening does not seem to create anxiety in women who are given a clear result after a mammogram .
The incidence of breast cancer and mortality increases with age , and the GDG extrapolated that the absolute health benefits are greater in women aged 45 to 49 than those aged 40 to 44 years .
However , for the 45- to 49-year age group , the higher breast cancer incidence and mortality compared with women between the ages of 40 and 44 , as well as observational evidence showing a greater benefit in this age group ( 33 ) , led the GDG to judge that the balance of health effects probably favors screening , although the required re sources for screening likely differ across setting s ( 34 , 35 ) .
Other EtD criteria also were generally in favor of implementing organized mammography screening in this age group .
Despite intensified efforts by the European Council since 2003 , the implementation of organized , population -based mammography screening is not uniform across Europe and depends greatly on the policies in place in different countries , the organization of health care , and available re sources ( 1 ) .
Since the last edition of the European Guidelines on Breast Cancer Screening and Diagnosis was published in 2006 ( 2 ) , new evidence regarding breast cancer and innovation in guideline methodology prompted the European Commission Initiative on Breast Cancer ( ECIBC ) to develop new evidence -based recommendations ( in short , the European Breast Guidelines ) .
These guidelines inform women , health professionals , and policymakers about important questions related to organized mammography screening and breast cancer diagnosis , but recommendations may apply in context s in which organized screening programs are not in place .
Women generally consider these undesirable effects acceptable ( low certainty of evidence ) , and a systematic review suggested that women place a relatively low value on the psychosocial and physical effects of false-positive results and overdiagnosis ; however , some studies raised concerns about whether women fully underst and the result ing implication s ( 15 ) .
How Often Should Women Attend an Organized Mammography Screening Program ?
One-view breast tomosynthesis versus two-view mammography in the Malmö Breast Tomosynthesis Screening Trial (MBTST): a prospective, population-based, diagnostic accuracy study.
BACKGROUND Digital breast tomo synthesis is an advancement of the mammographic technique , with the potential to increase detection of lesions during breast cancer screening . The main aim of the Malmö Breast Tomo synthesis Screening Trial ( MBTST ) was to investigate the accuracy of one-view digital breast tomo synthesis in population screening compared with st and ard two-view digital mammography . METHODS In this prospect i ve , population -based screening study , of women aged 40 - 74 years invited to attend national breast cancer screening at Skåne University Hospital , Malmö , Sweden , a r and om sample was asked to participate in the trial ( every third woman who was invited to attend regular screening was invited to participate ) . Participants had to be able to speak English or Swedish and were excluded from the study if they were pregnant . Participants underwent screening with two-view digital mammography ( ie , craniocaudal and mediolateral oblique views ) followed by one-view digital breast tomo synthesis with reduced compression in the mediolateral oblique view ( with a wide tomo synthesis angle of 50 ° ) at one screening visit . Images were read with masked double reading and scoring by two separate reading groups , one for each method , made up of seven radiologists . Any cancer detected with a malignancy probability score of three or higher by any reader in either group was discussed in a consensus meeting of at least two readers , from which the decision of whether or not to recall the woman for further investigation was made . The primary outcome measures were sensitivity and specificity of breast cancer detection . Secondary outcome measures were screening performance measures of cancer detection , recall , and interval cancers ( cancers clinical ly detected between screenings ) , and positive predictive value for screen recalls and negative predictive value of each method . Outcomes were analysed in the per- protocol population . Follow-up of the participants for at least 2 years allowed for identification of interval cancers . This trial is registered with Clinical Trials.gov , number NCT01091545 . FINDINGS Between Jan 27 , 2010 , and Feb 13 , 2015 , of 21 691 women invited , 14 851 ( 68 % ) agreed to participate . Three women withdrew consent during follow-up and were excluded from the analyses .  139 breast cancers were detected in 137 ( < 1 % ) of 14 848  women . Sensitivity was higher for digital breast tomo synthesis than for digital mammography ( 81·1 % , 95 % CI 74·2 - 86·9 , vs 60·4 % , 52·3 - 68·0 ) and specificity was slightly lower for digital breast tomo synthesis than was for digital mammography ( 97·2 % , 95 % CI 97·0 - 97·5 , vs 98·1 % , 97·9 - 98·3 ) . The proportion of cancers detected was significantly higher with digital breast tomo synthesis than with digital mammography ( 8·7 cancers per 1000 women screened , 95 % CI 7·3 - 10·3 vs 6·5 cancers per 1000 screened , 5·2 - 7·9 ; p<0·0001 ) . The proportion of women recalled after discussion was higher among cancers detected by digital breast tomo synthesis than for those detected by digital mammography after consensus ( 3·6 % , 95 % CI 3·3 - 3·9 vs 2·5 % , 2·2 - 2·8 ; p<0·0001 ) . The positive predictive value for screen recalls was 24·1 % ( 95 % CI 20·5 - 28·0 ) for digital breast tomo synthesis and 25·9 % ( 21·6 - 30·7 ) for digital mammography , and the negative predictive value was 99·8 % ( 99·7 - 99·9 ) and 99·6 % ( 99·4 - 99·7 ) , respectively . The proportion of women who developed interval cancers after trial screening was 1·48 cancers per 1000 women screened ( 95 % CI 0·93 - 2·24 ) . INTERPRETATION Breast cancer screening by use of one-view digital breast tomo synthesis with a reduced compression force has higher sensitivity at a slightly lower specificity for breast cancer detection compared with two-view digital mammography and has the potential to reduce the radiation dose and screen-reading burden required by two-view digital breast tomo synthesis with two-view digital mammography . FUNDING The Swedish Cancer Society , The Swedish Research Council , The Breast Cancer Foundation , The Swedish Medical Society , The Crafoord Foundation , The Gunnar Nilsson Cancer Foundation , The Skåne University Hospital Foundation , Governmental funding for clinical research , The South Swedish Health Care Region , The Malmö Hospital Cancer Foundation and The Cancer Foundation at the Department of Oncology , Skåne University Hospital
For example , mammography screening does not seem to create anxiety in women who are given a clear result after a mammogram .
The incidence of breast cancer and mortality increases with age , and the GDG extrapolated that the absolute health benefits are greater in women aged 45 to 49 than those aged 40 to 44 years .
However , for the 45- to 49-year age group , the higher breast cancer incidence and mortality compared with women between the ages of 40 and 44 , as well as observational evidence showing a greater benefit in this age group ( 33 ) , led the GDG to judge that the balance of health effects probably favors screening , although the required re sources for screening likely differ across setting s ( 34 , 35 ) .
Other EtD criteria also were generally in favor of implementing organized mammography screening in this age group .
Despite intensified efforts by the European Council since 2003 , the implementation of organized , population -based mammography screening is not uniform across Europe and depends greatly on the policies in place in different countries , the organization of health care , and available re sources ( 1 ) .
Since the last edition of the European Guidelines on Breast Cancer Screening and Diagnosis was published in 2006 ( 2 ) , new evidence regarding breast cancer and innovation in guideline methodology prompted the European Commission Initiative on Breast Cancer ( ECIBC ) to develop new evidence -based recommendations ( in short , the European Breast Guidelines ) .
These guidelines inform women , health professionals , and policymakers about important questions related to organized mammography screening and breast cancer diagnosis , but recommendations may apply in context s in which organized screening programs are not in place .
Women generally consider these undesirable effects acceptable ( low certainty of evidence ) , and a systematic review suggested that women place a relatively low value on the psychosocial and physical effects of false-positive results and overdiagnosis ; however , some studies raised concerns about whether women fully underst and the result ing implication s ( 15 ) .
How Often Should Women Attend an Organized Mammography Screening Program ?