Breast Screening in Germany

Based on the data of large randomized studies, on data and experience from other, mainly European countries, where structured service screening has meanwhile been offered for many years, and on extensive reconsiderations of advantages and risks, in 2002 the German parliament had decided to introduce service screening in Germany. Meanwhile strict regulations have been issued for a comprehensive screening program. The goal of the program is to assure high quality of technique and of diagnosis, as well as adequate further assessment and treatment of screening-detected lesions to warrant both high rate of detection and a minimum of potential side effects. Such side effects could e.g. occur with a too high rate of false alarm or with inadequate surgical biopsies of discrete changes that eventually proved to be benign. For this purpose the program strictly follows the ‘European Guidelines for Quality Assurance in Mammography Screening and Diagnosis’. Significant educational demands and structural changes are imposed on doctors and personnel who want to participate in the program. The changes and their indicated goals are described and explained. The program, which is associated with fundamental alterations within our health system, is presently starting in Germany. The demanded strict documentation will allow close monitoring of the results, which will be evaluated.