Brustkrebsfrüherkennung: Zielgruppen, Methoden, Nutzen und Nebenwirkungen

Background: The benefits and disadvantages of breast cancer screening programs are the subject of current discussion. Aim: The aim of this article is to summarize the current literature on target groups, methods, benefits, and side effects of early detection programs for breast cancer. Material and Methods: This article is based on a selective PubMed search using key words, publications of the Robert Koch Institute, the reports of the German organizations the “Mammography Cooperative,” the “Federal Joint Committee,” and the “Institute for Quality and Efficiency in Healthcare.” Results: Target groups for an early detection program for breast cancer are women in the age group 50 to 69 years (German Mammography Screening), women with hereditary breast cancer, and women who received radiotherapy of the chest wall during childhood and adolescence to treat malignancies. According to international randomized controlled trials, with mammography every 2 years and a participation rate of 65–85 %, women in the age group 50–69 show a breast cancer mortality reduction of 20 %. MRI-based early detection programs in women with hereditary breast cancer lead to the discovery of tumors at lower stages and significantly improved metastasis-free survival. The most significant side effect of the mammography-based screening program is over-diagnosis, the estimation of which varies greatly in the literature. The vast majority of international recommendations are in favor of mammography screening programs. Discussion: In the future a more risk-adapted screening program for the general population would be desirable, to improve the benefit–risk balance.