Breast Cancer Screening and Diagnosis: A Synopsis of the European Breast Guidelines

Holger J. Schünemann(McMaster University), Lerda Donata(Joint Research Centre), Cecily Quinn(St. Vincent's University Hospital), Markus Follmann(German Cancer Society), Pablo Alonso‐Coello(Iberoamerican Cochrane Centre), Paolo Giorgi Rossi(Azienda Sanitaria Unità Locale di Reggio Emilia), Annette Lebeau, Lennarth Nyström(Umeå University), Mireille J. M. Broeders(Radboud University Medical Center), Lydia Ioannidou-Mouzaka(National and Kapodistrian University of Athens), Stephen W. Duffy(Queen Mary University of London), Bettina Borisch(University of Geneva), Patricia Fitzpatrick(Health Service Executive), Solveig Hofvind(Cancer Registry of Norway), Xavier Castells(Hospital del Mar Research Institute), Livia Giordano, Carlos Canelo‐Aybar(Iberoamerican Cochrane Centre), Sue Warman, Robert E. Mansel(Cardiff University), Francesco Sardanelli(University of Milan), Elena Parmelli(Joint Research Centre), Axel Gräwingholt, Zuleika Saz‐Parkinson(Joint Research Centre), for the European Commission Initiative on Breast Cancer (ECIBC) Contributor Group*
Annals of Internal Medicine
November 25, 2019
Cited by 287

Abstract

Description: The European Commission Initiative for Breast Cancer Screening and Diagnosis guidelines (European Breast Guidelines) are coordinated by the European Commission's Joint Research Centre. The target audience for the guidelines includes women, health professionals, and policymakers. Methods: An international guideline panel of 28 multidisciplinary members, including patients, developed questions and corresponding recommendations that were informed by systematic reviews of the evidence conducted between March 2016 and December 2018. GRADE (Grading of Recommendations Assessment, Development and Evaluation) Evidence to Decision frameworks were used to structure the process and minimize the influence of competing interests by enhancing transparency. Questions and recommendations, expressed as strong or conditional, focused on outcomes that matter to women and provided a rating of the certainty of evidence. Recommendations: This synopsis of the European Breast Guidelines provides recommendations regarding organized screening programs for women aged 40 to 75 years who are at average risk. The recommendations address digital mammography screening and the addition of hand-held ultrasonography, automated breast ultrasonography, or magnetic resonance imaging compared with mammography alone. The recommendations also discuss the frequency of screening and inform decision making for women at average risk who are recalled for suspicious lesions or who have high breast density.


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