Should organised mammography screening vs. no mammography screening be used for early detection of breast cancer in women aged 45 to 49?

The decision on this recommendation takes into account the balance between desirable and undesirable effects that probably favours organised mammography screening for women aged 45 to 49 in the context of moderate certainty of the evidence.

New evidence suggested that the cost-effectiveness probably favours organised mammography screening.

This recommendation does not apply to women at higher risk of developing breast cancer, who are outside the scope of the European breast cancer guidelines.

The GDG discussed how the implementation of the intervention may be challenged depending on the number of women included in the age range considered (i.e. adding 5 years for programs that are currently screening is less feasible than adding age groups by yearly strata) and the time interval used for screening (i.e. annual vs biennial).

Organisational issues and the backlog caused by the pandemic in the last years should also be considered.

Within EC initiative on Breast Cancer, quality indicators to measure the performance of breast cancer screening programmes have been identified.

The GDG highlighted the importance of programmatic research in absence of trial data.

The GDG considered also as research priorities:

• Evaluating the effects of the intervention, time intervals, risk factors and stratification of women, as well as context specific cost-effectiveness in this age group, in particular countries or programmes that are already implementing this approach.
• Conducting studies addressing the role of other screening modalities in this population.