Invitation

• Once every 2 years, women aged between 50 and 75 are invited to visit a mammography unit to be screened for breast cancer. The invitation is for a specific date, time and location, but alternative appointments can be arranged on request through a specific website or by telephone.
• The invitation is accompanied by information about the aim of screening, about the advantages and disadvantages of screening, about the procedure and about the organisational and statutory arrangements.

Mammography

• Most of the screening takes place in mobile mammography units. Screening involves producing mammograms of the woman’s breasts.
• Within a few days, the mammograms are assessed by 2 specially trained radiologists, working independently of each other.
• Within 2 weeks of screening, the woman receives a letter informing her of the assessment’s result.
• Women neither attending screening nor indicating that they do not wish to participate receive a reminder a few weeks later.

Referral

The various possible assessment results and the implications of each are described below. Results are expressed in the form of BI-RADS scores; BI-RADS stands for Breast Imaging Reporting and Data System.

• BI-RADS 1: Normal; no referral.
• BI-RADS 2: Benign abnormality; no referral.
• BI-RADS 0: Insufficient information to give a BI-RADS score; further examination necessary to establish whether the woman has a pseudo-abnormality, a benign abnormality or a malign abnormality; referral.
• BI-RADS 4: Malignancy suspected but picture not typical; referral.
• BI-RADS 5: Malignancy strongly suspected; referral.
• In cases where breast cancer is suspected, the woman is advised to contact her GP and provided with information about the subsequent diagnostic procedure. In addition, the subject’s GP is informed about the suspicious result and is asked to contact his/her patient.
• In cases where breast cancer is not suspected, the woman is cautioned that screening cannot guarantee the absence of cancer and is advised to contact her GP if she should experience abnormal changes before her next screening cycle.

Coordination with the health care system (diagnosis and treatment)

At present, 2,45% of the participating women are referred to a hospital for further examination. Research has shown that rapid diagnosis and treatment is desirable for reasons of emotional well-being. The responsible screening organisations monitor a referred woman until the GP has reported a referral.