Breast cancer prevention in the ASL of Lecco: local guidelines for a mammographic screening program

Summary Breast cancer is the first cause of mortality due to cancer in women, with an incidence rate in Lombardy of 80.6/cases per 100,000 women every year. Screening through mammography in women aged 50 to 69 is widely believed to be effective in reduc- ing mortality. In Italy few cities and regions are running orga- nized screening programs, while the request for breast cancer prevention is increasing. For these reasons the Health Agency of Lecco (ASL Lecco) organized and developed a Breast Cancer Screening program as a Strategic issue in the years 1999-2001. The organization process started with the analysis of the breast cancer incidence and the frequency of «spontaneous screening» in the Province of Lecco. Afterward two work groups were es- tablished: an Operative Project Group with the aim of produc- ing local guidelines and of preparing the operating plan; and a Technical Committee to validate the guidelines and to provide scientific and technical aid to the operative group. According to the guidelines, women aged between 50 and 69 are invited by letter every 2 years with a prearranged appointment that can be changed by phone. An Organisation and Evaluation Unit and a Breast Cancer Diagnostic Unit are activated.