Summary of the Updated Stage 3 Guideline for Early Detection of Breast Cancer in Germany 2008

The guideline EARLY DETECTION OF BREAST CANCER IN GERMANY aims to assist physicians, healthy women and patients in their decision-making by providing information and formal consensus-based recommendations regarding the diagnostic chain for the early detection of breast cancer. This guideline updates the previous version published in 2003. The guideline is a precondition to establish an effective and efficient national early breast cancer detection program in accordance with the requirements for cancer control programs of the European Council and the WHO. The core imaging technique of an early detection program is mammography, used either in screening or diagnostic settings. Breast healthcare outcomes can be improved by embedding this imaging technology in a quality-assured diagnostic chain. The guideline offers state-of-the-art scientific and medical knowledge based on evidence and consensual recommendations covering all multidisciplinary aspects of the diagnostic chain including clinical history taking, risk consultation and risk communication, breast health awareness, physical breast examination, breast imaging, interventional guided biopsy, excision biopsy and breast pathology. The guideline includes formal measures such as quality indicators to assure resource availability, process quality and outcomes of the diagnostic chain. Early detection of breast cancer is at present the most promising means of optimizing the diagnosis and treatment of breast cancer and consequently of reducing mortality and morbidity while improving the quality of life of survivors. The aim is to detect breast cancer during the pre-invasive or early invasive stage to obtain a five-year survival rate of more than 90 % with adequate treatment. Detecting more non invasive breast cancers might even help to reduce the incidence of disease. Within the scope of secondary prevention it offers the chance of cure during the early stage of disease with less radical and thus less straining modes of treatment..