Breast cancer. From mammography screening to a complete concept of women's health care

Mammography screening is not synonymous with early detection of breast cancer, but rather the performance and reading of high standard mammograms in an invited target population at higher risk for breast cancer without any physician-patient contact. Quality assurance of mammography is a management plan aiming to optimize the risk-benefit relation of the procedures applied by defining the requirements for technical and personnel standards. Early detection of breast cancer is a comprehensive multidisciplinary and multiprofessional concept of women's health care. Together with treatment and surveillance, it forms a national breast cancer control program. To establish an early breast cancer detection program, systematic highly qualified guidelines on good clinical practice were finalized for Germany according to the national guideline protocol of the Association of the Scientific Medical Societies in Germany (AWMF). The guideline recommendations comprise the full chain of care for early detection and diagnosis of breast cancer and its implementation respecting the specific conditions and resources of the German health care system. Continuous quality improvements of an effective and efficient guideline-compliant net of health care (including breast centers and disease management programs) rely indispensably on data management and its processing within clinical and epidemiological cancer registries.