Digital Breast Tomosynthesis versus Digital Mammography for Detection of Early-Stage Cancers Stratified by Grade: A TOSYMA Subanalysis

[Structured screening for sporadic breast cancer]

BACKGROUND

The aim of secondary prevention of breast cancer is to detect the disease at the earliest curable stage and thus to reduce breast cancer-specific mortality. To this end, the nationwide population-based mammography screening program (MSP) was set up in Germany in 2005 in addition to an interdisciplinary prevention project for high-risk groups.

OBJECTIVE

Overview of the current state of the MSP, the upcoming age expansion, and potential further developments.

MATERIAL AND METHODS

Narrative review article with topic-guided literature and data search.

RESULTS

Approximately 50% of the 70,500 new cases of breast cancer that occur each year are related to the age group of the MSP. 10 years after introduction of the MSP, the incidence of advanced breast cancer stages and breast cancer-related mortality of the screening target group have steadily decreased by about one quarter, while no relevant trends were seen in the neighboring age groups at the population level.

CONCLUSION

The MSP has effectively contributed to a reduction of breast cancer mortality. With the expansion of the age groups to 45-75 years, more women have access to structured, quality assured screening. With the use of advanced stratifications and diagnostics as well as artificial intelligence, the MSP could be further optimized.