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Introduction: Breast cancer screening in women of 70 years of age or older remains controversial due to a lack of studies that include women of this age. Methods: This ecological study evaluated data from the Brazilian National Health Service (SUS) on breast cancer screening and staging in this age group compared to 50-69-year olds, for Brazil as a whole and for its geographical regions, between 2013 and 2019. A secondary database was obtained from the outpatient data system of the SUS's Informatics Department, the Brazil Oncology Panel, the Brazilian Institute of Geography and Statistics, the Supplementary Health Agency and the Online Mortality Atlas. Results: There was a marked reduction in screening in women ≥70 years of age (annual percent change [APC] -3.5; p < 0.001) compared to those of 50-69 years of age (APC-2.2; p = 0.010). There was a trend towards an increase in clinical staging, with a greater occurrence of stages III and IV in the ≥70 group (44.3%) compared to the women of 50-69 years of age (40.8%; p < 0.001). Conclusion: Considering the increasing age of the Brazilian population and the heterogeneity among older adults women, screening for the over-70s within the SUS merits greater debate insofar as the implementation of public policies is concerned.

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Objectives: This study aimed to evaluate COVID-19 effects on breast cancer screening and clinical stage at diagnosis in patients of 50-69 years of age receiving care within the public healthcare network (SUS) in 2013-2021 in Brazil and its macro-regions. Methods: This ecological study used Poisson regression to analyze trends in screening and staging. A secondary database was formed using SUS sources: outpatient data system of the SUS network and Oncology-Brazil Panel. Results: There was a reduction in screening, with an annual percent change of -5.9 (p < 0.022). The number of notified cases fell by 31.5% in 2020-2021 compared to 2018-2019. There was a 10.7% increase in the proportion of stage III/IV cases (p < 0.001) in 2020-2021 compared to 2013-2019, now surpassing the number of cases of early stage breast cancer. Conclusion: COVID-19 led to a reduction in breast cancer screening and an expressive increase in advanced tumors in users of the public healthcare network. Urgent interventions in public policies are required as the negative effects of the pandemic on the diagnosis/treatment of breast cancer are becoming apparent even earlier than expected.

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The Breast Cancer Revealed initiative was designed and conducted to know the status of breast cancer at each point of breast cancer care, through i) prevention, ii) detection, iii) diagnosis, iv) treatment, and iv) the capacity of our health systems. The expert panel from 11 Latin American countries identified several strategies and proposed high impact priorities, including implementation of prevention policies, improve primary healthcare capacity for breast cancer screening, have adequate infrastructure to make effective and timely diagnoses, have a multidisciplinary team in the treatment process, access to a variety of treatments for all types of patients, have a coordinated and articulated system from primary care to specialized hospital. In a region with limited resources, prioritization in high-impact strategies for breast cancer control could lead to improved clinical outcomes and quality of life for our patients.

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Objective: To present the updated recommendations of the Brazilian College of Radiology and Imaging Diagnosis, the Brazilian Society of Mastology and the Brazilian Federation of Gynecology and Obstetrics Associations for breast cancer screening in Brazil. Methods: Between January 2012 and July 2022, searches for scientific evidence published in MEDLINE, Embase, Cochrane Library, EBSCO, CINAHL and LILACS were carried out. The recommendations were based on this evidence, with the consensus of a committee of experts from the three institutions. Recommendations: The annual mammography screening is recommended for normal-risk patients aged between 40 and 74 years. For women aged more than 75 years, it is reserved for those whose life expectancy is longer than seven years. Women whose risk is higher than normal, such as those with dense breasts, personal history of atypical lobular hyperplasia, classic in situ lobular carcinoma, atypical ductal hyperplasia, women undergoing breast cancer treatment or thoracic irradiation before the age of 30, or those with genetic mutation or strong family history, benefit from complementary screening, being considered in an individual manner. Tomosynthesis is an evolution of mammography and should be considered in screening whenever accessible and available

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Abstract Objective To present the update of the recommendations of the Brazilian College of Radiology and Diagnostic Imaging, the Brazilian Society of Mastology and the Brazilian Federation of Associations of Gynecology and Obstetrics for breast cancer screening in Brazil. Methods Scientific evidence published in Medline, EMBASE, Cochrane Library, EBSCO, CINAHL and Lilacs databases between January 2012 and July 2022 was searched. Recommendations were based on this evidence by consensus of the expert committee of the three entities. Recommendations Annual mammography screening is recommended for women at usual risk aged 40-74 years. Above 75 years, it should be reserved for those with a life expectancy greater than seven years. Women at higher than usual risk, including those with dense breasts, with a personal history of atypical lobular hyperplasia, classic lobular carcinoma in situ, atypical ductal hyperplasia, treatment for breast cancer or chest irradiation before age 30, or even, carriers of a genetic mutation or with a strong family history, benefit from complementary screening, and should be considered individually. Tomosynthesis is a form of mammography and should be considered in screening whenever accessible and available.

Resumo Objetivo Apresentar a atualização das recomendações do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem da Sociedade Brasileira de Mastologia e da Federação Brasileira das Associações de Ginecologia e Obstetrícia para o rastreamento do câncer de mama no Brasil. Métodos Foram pesquisadas evidências científicas publicadas nas bases de dados Medline EMBASE Biblioteca Cochrane EBSCO CINAHL e Lilacs entre janeiro de 2012 e julho de 2022. As recomendações foram baseadas nessas evidências por consenso do comitê de especialistas das três entidades. Recomendações A mamografia anual é recomendada para mulheres com risco habitual entre 40 e 74 anos. Acima de 75 anos deve ser reservado para aqueles com expectativa de vida superior a sete anos. Mulheres com risco maior do que o normal incluindo aquelas com mamas densas com história pessoal de hiperplasia lobular atípica carcinoma lobular in situ clássico hiperplasia ductal atípica tratamento para câncer de mama ou irradiação de tórax antes dos 30 anos ou ainda portadoras de doença genética mutação ou com forte histórico familiar beneficiam-se de triagem complementar e devem ser considerados individualmente. A tomossíntese é uma forma de mamografia e deve ser considerada na triagem sempre que acessível e disponível.

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Objective: This study aims to evaluate the impact of the Pink October Campaign on the increase in mammographic screening in Brazil. Study design: Ecological observational study, based on retrospective data. Methods: Brazilian national screening database (DATASUS/SISMAMA/Information System on Breast Cancer) was used as a data source and is publicly available for download and analysis. We report screening numbers and outcome rates from January 2017 to December 2021 comparing statistically (ANOVA test, post-Tukey test), age groups, regions of Brazil, and the four quarters of the year. Results: During the study period, the average number of exams performed monthly over the five years was 137,400.117. An increase in the number of mammograms performed in October was identified, as well as in the two following months, respectively 33%, 39%, and 22%, with statistical significance (p = 0.000) in relation to the three quarters of the year. In addition, in the other months, we found values below the monthly average. Statistical difference was not found in the increase in mammograms considering age groups (p = 0.5) and different regions of the country (p = 0.6). Conclusions: This study showed an increase in mammographic screening in the three months following the Pink October Campaign, so we should intensify similar actions throughout the year and not just in October.

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Abstract Objective. To identify associations between sociodemographic variables and stages of change and evaluate differences between health belief model variables and these stages. Methods. This cross-sectional descriptive study included 612 women aged 40 years and older admitted to a public hospital in the Northeast of Mexico. The participants answered the health belief model scale and selected the statement that best reflected their experience with mammography screening. The association between sociodemographic and clinical variables and the mammography stages of change was assessed using X2, and the groups of stages of change were compared using one-way ANOVA and Games-Howell post-hoc tests. Results. There was a significant association between age and the stages of action and maintenance. Breast cancer screening methods such as breast self-examination and clinical breast examination were more common among women in the stages of maintenance and relapse. There were differences between pre-contemplation and the more advanced stages in all dimensions except in the perceived seriousness p <.001. Self-efficacy and health motivation were different among women at the stage of contemplation, maintenance, and relapse. Conclusions. Perceived self-efficacy and health motivation may increase adherence to mammography screening.

Resumen El objetivo de la investigación fue identificar la asociación entre las variables sociodemográficas y las etapas de cambio para el uso de la mamografía y evaluar si existen diferencias entre las dimensiones del modelo de creencias en salud y las etapas de cambio. El diseño de este estudio es transversal descriptivo, se realizó de enero de 2017 a enero de 2018, incluyó a 612 mujeres de 40 años en adelante que asistían a un hospital de atención terciaria en el noreste de México. Las participantes firmaron el consentimiento informado y respondieron a la escala del modelo de creencias en salud y seleccionaron la declaración que mejor reflejaba su experiencia con la mamografía. La asociación entre las variables sociodemográficas y clínicas y las etapas de cambio de la mamografía se evaluó mediante X2, y los grupos de etapas de cambio se compararon mediante pruebas post hoc de ANOVA unidireccional y Games-Howell. Se encontró una asociación significativa entre la edad y las etapas de cambio de acción y mantenimiento. Los métodos de detección del cáncer de mama, como la autoexploración de mama y el examen clínico de mama, fueron más comunes entre las mujeres en las etapas de mantenimiento y recaída. Se obtuvieron diferencias significativas entre las etapas de pre-contemplación y las etapas más avanzadas en todas las dimensiones de creencias de salud, excepto en la seriedad percibida p <.001. La autoeficacia y la motivación para la salud fueron diferentes entre las mujeres en la etapa de contemplación, mantenimiento y recaída. La identificación de las etapas de cambio para la adopción de mamografías puede ayudar a desarrollar e implementar estrategias de intervención más efectivas. Además, la autoeficacia percibida y la motivación para la salud pueden aumentar la adherencia a la mamografía como método de detección del cáncer de mama.

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Our lab has built a next-generation tomosynthesis (NGT) system utilizing scanning motions with more degrees of freedom than clinical digital breast tomosynthesis systems. We are working toward designing scanning motions that are customized around the locations of suspicious findings. The first step in this direction is to demonstrate that these findings can be detected with a single projection image, which can guide the remainder of the scan. This paper develops an automated method to identify findings that are prone to be masked. Perlin-noise phantoms and synthetic lesions were used to simulate masked cancers. NGT projections of phantoms were simulated using ray-tracing software. The risk of masking cancers was mapped using the ground-truth labels of phantoms. The phantom labels were used to denote regions of low and high risk of masking suspicious findings. A U-Net model was trained for multiclass segmentation of phantom images. Model performance was quantified with a receiver operating characteristic (ROC) curve using area under the curve (AUC). The ROC operating point was defined to be the point closest to the upper left corner of ROC space. The output predictions showed an accurate segmentation of tissue predominantly adipose (mean AUC of 0.93). The predictions also indicate regions of suspicious findings; for the highest risk class, mean AUC was 0.89, with a true positive rate of 0.80 and a true negative rate of 0.83 at the operating point. In summary, this paper demonstrates with virtual phantoms that a single projection can indeed be used to identify suspicious findings.

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Introdução: Avaliar o perfil clínico e epidemiológico das pacientes octogenárias diagnosticadas com câncer de mama em um serviço oncológico de referência do Sul de Santa Catarina entre os anos de 2010 a 2018. Métodos: Realizou-se um estudo transversal, retrospectivo, descritivo com coleta de dados secundária e abordagem quantitativa, a partir de prontuários de pacientes octogenárias com câncer de mama. Foram avaliados 50 prontuários; desses, 18 preencheram critérios de inclusão e compuseram a amostra final. Os dados foram classificados de acordo com as características epidemiológicas e clínicas. Resultados: As variáveis epidemiológicas mostraram que a média de idade foi 84,11 anos. 12 das 17 mulheres eram ex-tabagistas, 11 já haviam gestado, 6 não continham histórico familiar de câncer de mama. Entre as características clínicas, o estágio mais encontrado foi o estágio II (4 pacientes), seguido dos estágios I e III e 8 não trouxeram esse dado. O tipo histológico mais comum foi o carcinoma invasivo sem outra especificação. Na imuno-histoquímica, o subtipo mais comum foi o Luminal A (6), seguido pelo Luminal B (3), Triplo negativo (3), Superexpressão HER2 (2) e Luminal HER 2(1). Em relação ao tratamento, 9 das pacientes realizaram cirurgia conservadora e 14 fizeram uso de terapia hormonal. Conclusão: Os resultados encontrados são concordantes com os descritos na literatura, quando analisados tipo histológico e imuno-histoquímico. Em relação ao tratamento, ainda não há consenso de qual conduta aplicar nestas pacientes devido à individualidade das mesmas. O tratamento hormonal mostrou-se favorável a estas pacientes, mas ainda são necessários mais estudos.

Introduction: To evaluate the clinical and epidemiological profile of octogenarian patients diagnosed with breast cancer in a referral oncology service in southern Santa Catarina between 2010 and 2018. Methods: A cross-sectional, retrospective, descriptive study was carried out with secondary data collection and a quantitative approach, from medical records of octogenarian patients with breast cancer. Fifty medical records were evaluated, of which 18 met the inclusion criteria and formed the final sample. Data were classified according to epidemiological and clinical characteristics. Results: The epidemiological variables showed that the mean age was 84.11 years. Twelve of the 17 women were former smokers, 11 had already been pregnant, 6 had no family history of breast cancer. Among clinical characteristics, the most common stage was stage II (4 patients), followed by stages I and III, and in 8 this information was missing. The most common histological type was invasive carcinoma not otherwise specified. In immunohistochemistry, the most common subtype was Luminal A (6), followed by Luminal B (3), Triple negative (3), HER2 Overexpression (2) and Luminal HER 2(1). Regarding treatment, 9 of the patients under-went conservative surgery and 14 used hormone therapy. Conclusion: The findings are in agreement with those described in the literature, when analyzed histologically and immunohistochemically. Regarding treatment, there is still no consensus on which conduct to apply in these patients due to their individuality. Hormonal treatment appeared to be favorable to these patients, but further studies are still needed.

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BACKGROUND: Screening mammography for breast cancer (BC) is a current strategy that reduces the mortality of BC by up to 30 %. Although mastectomy has been an important component of treatment for decades, conservative surgery (lumpectomy) has become the gold-standard approach for most cases, yet it depends on early detection of the BC. METHODS: This was an epidemiological study performed through DATASUS (2010-2018). We evaluated the temporal trend of screening mammograms, deaths from BC, and surgical procedures at national, regional and state levels. Statistical analysis was performed on VassarStat®-Website for Statistical Computation (Vassar College, New York, USA) and the R-software (R Foundation, v.4.0.3). RESULTS: During 2010-2018 there were 67,392 oncological mastectomies and 48,567 lumpectomies in Brazil's health system. Mastectomies decreased in the Northeast (-3.67 % ± 0.43 per year) and in Bahia state (-3.58 % ± 0.24 per year). Lumpectomies increased in Brazil (median 2.19 (-9.6 to 20.96)), the Northeast (median -12.07 (-25.8 to 9.43)) and Bahia (median 0.16 (-29.1 to 1.9)). Also, screening mammograms increased in Brazil (3.29 % ± 0.43), the Northeast (6.36 % ± 0.49) and Bahia (5.51 % ± 0.31), with 35,317,728 exams during this period. Deaths from BC increased annually in Brazil (+4.13 % ± 0.86), the Northeast (+4.76 % ± 1.45) and Bahia (+5.65 % ± 0.83). CONCLUSION: The number of mammograms related to the screening program increased in the years 2010-2018 in Brazil. Furthermore, we identified an increase in lumpectomies as opposed to mastectomies, and this approach is associated with a reduction in hospitalization days by almost a half, which in turn might result in a cost decrease and probably an earlier return to work.

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INTRODUCTION: In Uruguay, breast cancer has the highest incidence and mortality of all cancer in women. Knowledge of the distribution of risk factors related to disease development supports the implementation of prevention strategies in routine clinical practice. This study aimed to determine the epidemiological profile for breast cancer and the frequency of mammographic surveillance in the surveyed population. MATERIALS AND METHODS: A survey was conducted among Uruguayan women diagnosed with breast cancer who were assisted in the mastology unit of the oncology service of the Hospital de Clínicas in Montevideo, Uruguay, from September 1, 2018, to March 1, 2020. RESULTS: This study included 398 respondents, with a median (SD) age at diagnosis of 61 (34-86) years. A total of 310 respondents (78.0%) had 1 or more risk factors. Most women aged over 50 years (264 out of a total of 338 [78.1%]) underwent mammographic surveillance at least biennially. CONCLUSIONS: Consistent with international reports, most respondents had a risk factor. Among the group of respondents aged over 50 years, most underwent mammographic and clinical surveillance at least biennially. Although it is only possible to formulate conclusions about the surveyed women because of the study design, the obtained data further our understanding of the epidemiological profile of the Uruguayan population, which can contribute to prevention practices.

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Although the Champion's Health Belief Model Scale for breast cancer screening has been adapted and validated in different populations worldwide, a Spanish version for the Latin American population is still not available. The aim of this study was to adapt and validate the Spanish version of the Champion's Health Belief Model Scale for mammograms for use with Mexican women and determine the sociodemographic, clinical, and health belief model variables which influence undergoing a mammogram. A descriptive, cross-sectional study was designed. Participants included 612 women aged 40 years and above who attended a public tertiary hospital. An exploratory factor analysis was conducted, from which six factors with adequate loadings were obtained. In addition, Cronbach's alpha was used to obtain a reliability coefficient of 0.68-0.94. To obtain criterion validity, a binary logistic regression analysis was conducted, with the mammogram being the dependent variable and sociodemographic, clinical, and health belief model dimensions being the predictors; perceived benefits was the variable that most influenced the obtaining of mammography. This Spanish version of the Champion's Health Belief Model Scale for breast cancer screening for Mexican women was found to be valid and reliable, which means it could be a useful tool in identifying beliefs surrounding breast cancer screening.

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ABSTRACT Objective To evaluate the impact of COVID-19 pandemic on breast cancer diagnosis in a breast imaging center. Methods This was a retrospective cohort study that included women submitted to breast exams and procedures in a private hospital in São Paulo, SP, Brazil, as from the period of most strict social isolation measures, in 2020 (separated in first period of social isolation, March 24 to June 21, 2020, and second period, June 22 to December 31, 2020), as compared to the same period in 2019. The number of exams, cancer detection rates, pathologic findings and risk factors were analyzed. Results A total of 32,144 patients were included in the study. Breast imaging exams and procedures decreased by 78.9% in the first period, and 2.7% in the second period, in 2020. By the end of 2020, the number of breast cancer lesions detected was just six cases less than in 2019, although the number of patients submitted to mammograms was 35% lower. Conclusion There was a drop in number of breast exams and cancer diagnoses in the first 90 days of the pandemic. The decrease in diagnosis of cancer was partially compensated in the second period, but the number of patients submitted to mammograms by the end of 2020 was lower, still considering a large number of patients with delayed exams.

RESUMO Objetivo Avaliar o impacto da pandemia da COVID-19 no diagnóstico de câncer de mama em um centro de imagem de mama. Métodos Estudo de coorte retrospectivo que incluiu mulheres submetidas a exames e procedimentos de mama em um hospital privado em São Paulo, SP, Brasil, no período de medidas mais rigorosas de isolamento social em 2020 (dividido em primeiro período, de 24 de março a 21 de junho de 2020, e em segundo período, de 22 de junho a 31 de dezembro de 2020), comparado com o mesmo período de 2019. Foram analisados o número de exames, as taxas de detecção de câncer, os achados patológicos e os fatores de risco. Resultados Foram incluídas 32.144 pacientes. Os exames e os procedimentos de imagem da mama em 2020 tiveram redução de 78,9% no primeiro período e 2,7% no segundo período. Ao final de 2020, foram diagnosticadas com câncer de mama seis pacientes a menos do que em 2019, embora o número de pacientes submetidas à mamografia tenha sido 35% menor. Conclusão Houve queda no número de exames de mama e de diagnósticos de câncer nos primeiros 90 dias da pandemia. A redução dos diagnósticos de câncer foi parcialmente compensada no segundo período, mas o número de pacientes submetidas a exames de mamografia até o final do ano foi menor, considerando ainda um grande número de pacientes com exames atrasados.

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Introduction: Digital breast tomosynthesis (DBT) may decrease recall rates (RRs) and improve positive predictive values (PPVs) and cancer detection rates (CDRs) versus full-field digital mammography (FFDM). The value of DBT has not been assessed in New Mexico's rural and minority population. Objectives of this study were to compare RRs, CDRs, and PPVs using FFDM+DBT versus FFDM in screening mammograms at the University of New Mexico between 2013 and 2016 and to qualitatively evaluate patient decision-making regarding DBT. Materials and Methods: RRs, CDRs, and PPVs with 95% confidence intervals and relative risk were calculated from 35,147 mammograms. The association between relative risk and mammography approach was tested using Pearson's chi-square test. Twenty women undergoing screening were interviewed for qualitative evaluation of decision-making. Results: From 2013 to 2016, RRs were 8.4% and 11.1% for FFDM+DBT and FFDM, respectively. The difference in RRs became more pronounced with time. No significant difference was observed in PPVs or CDRs. Qualitative interviews revealed that the majority had limited prior knowledge of DBT and relied on provider recommendations. Conclusion: In New Mexico women undergoing screening mammography, a 30% relative risk reduction in RRs was observed with FFDM+DBT. Qualitative interviews suggest that women are aware of and receptive to DBT, assuming adequate educational support. Clinical Trials.gov ID: NCT03979729.

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ABSTRACT BACKGROUND: Breast cancer worries are important determinants in relation to behavior favoring breast cancer screening. OBJECTIVE: To determine the effect of theory-based training to promote breast cancer screening among women with high and low levels of breast cancer worries. DESIGN AND SETTING: Randomized controlled trial, conducted in two family health centers. METHODS: In total, 285 women were recruited. Women with low levels of breast cancer worries were included in the first intervention group (112 women) and the first control group (112 women), while women with high levels of breast cancer worries were included in the second intervention group (37 women) and the second control group (43 women). Theory-based training to promote breast cancer screening was given to intervention groups. The women's willingness to undergo breast cancer screening and breast cancer worry scores were evaluated at 1, 3 and 6 months. RESULTS: The women in the low cancer-worry intervention group performed breast self-examination more in months 1 and 6 following the training, and the women in the high cancer-worry control group performed breast self-examination more in month 3 (P < 0.05). No difference between the women who had low or high levels of breast cancer worries were observed in relation to breast self-examination, clinical breast examination or mammography (P > 0.05). CONCLUSION: The level of worry did not affect the success of theory-based training, and the training was partially effective with regard to willingness to undergo breast cancer screening.

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In 2004 the Brazilian National Cancer Institute (INCA) established breast cancer screening guidelines for women in Brazil: annual clinical breast exam for women age 40-49 and biennial mammogram for women age 50-69. Healthcare provider's adherence to these guidelines is currently unknown. The objective of this study is to describe the perceptions and practices related to breast cancer screening among physicians, nurses, and health unit coordinators working in the network of primary healthcare units (HCUs) in Brazil. In 2011, 1600 primary HCUs were randomly sampled from all regions in Brazil. At each HCU the coordinator and one health professional were asked to participate in a telephone survey to gathered information on their knowledge, attitudes, and practices related to breast cancer screening. Participation rates for coordinators, physicians, and nurses were 78%, 34%, and 65% respectively. Health unit coordinators identified numerous barriers that prevent patients from receiving appropriate screening, many (44%) were unaware of INCA cancer screening guidelines. Despite a high perceived impact of INCA guidelines, a majority of physicians and nurses did not follow them. Most physicians and nurses recommended mammograms on an annual basis (~75%) and 50.9% of nurses and 25.1% of physicians initiated routine breast cancer screening in women under age 40. Physicians and nurses in Brazil screen at younger ages and more frequently than recommended by INCA guidelines. Given that primary HCUs are the source of health care for many women, interventions that educate healthcare providers on the appropriate ages and intervals for breast cancer screening may prove useful.

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In rural area, control of breast cancer is related to health promotion and early diagnosis, which includes knowledge, awareness, and stimulating behavioral change, emphasizing screening for disease. The present study was developed to assess the knowledge, attitude, and practice of rural women about early detection of breast cancer in the Primary Health Care Centre. This is a cross-sectional study in a Primary Health Care Centre with 243 rural women participating in the public health service. Data collection was made by a self-administered questionnaire which included sociodemographic characteristics, questions on breast cancer risk factors, screening, and diagnostic methods. Marks were attributed to each question and calculated for each section. Participants fell in three categories of knowledge, attitude, and practice: appropriate, regular and inappropriate. Knowledge, attitude, and practice of early detection methods were considered especially appropriate for those rural women with education and higher economic level, but inadequate responses to such methods were still significant. It is noted that there is still a significant number of rural women who do not have basic knowledge regarding early detection methods of breast cancer, contributing to the non-realization of these methods, as its advocates.

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OBJECTIVE: To present the current recommendations for breast cancer screening in Brazil, as devised by the Brazilian College of Radiology and Diagnostic Imaging, the Brazilian Breast Disease Society, and the Brazilian Federation of Gynecological and Obstetrical Associations. MATERIALS AND METHODS: We analyzed scientific studies available in the Medline and Lilacs databases. In the absence of evidence, the recommendations reflected the consensus of a panel of experts. RECOMMENDATIONS: Annual mammography screening is recommended for women 40-74 years of age. Among women ≥ 75 years of age, annual mammography screening should be reserved for those with an expected survival > 7 years. Complementary ultrasound should be considered for women with dense breasts. Complementary magnetic resonance imaging is recommended for women at high risk. When available, an advanced form of mammography known as tomosynthesis can be considered as a means of screening for breast cancer.

OBJETIVO: Apresentar as recomendações do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, da Sociedade Brasileira de Mastologia e da Federação Brasileira das Associações de Ginecologia e Obstetrícia para o rastreamento por imagem do câncer de mama no Brasil. MATERIAIS E MÉTODOS: Foram analisados os estudos científicos disponíveis nas bases científicas Medline e Lilacs. Na ausência de dados probatórios, as recomendações refletiram o consenso da comissão de especialistas. RECOMENDAÇÕES: O rastreamento mamográfico anual é recomendado para as mulheres entre 40 e 74 anos. Acima de 75 anos deve ser reservado para as mulheres que tenham expectativa de vida maior que 7 anos. O rastreamento complementar com ultrassonografia deve ser considerado para as mulheres com mamas densas. O rastreamento complementar com ressonância magnética é recomendado para as mulheres com alto risco. A tomossíntese é uma forma de mamografia que pode ser considerada para o rastreamento do câncer de mama, quando disponível.

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Abstract Objective: To present the current recommendations for breast cancer screening in Brazil, as devised by the Brazilian College of Radiology and Diagnostic Imaging, the Brazilian Breast Disease Society, and the Brazilian Federation of Gynecological and Obstetrical Associations. Materials and methods: We analyzed scientific studies available in the Medline and Lilacs databases. In the absence of evidence, the recommendations reflected the consensus of a panel of experts. Recommendations: Annual mammography screening is recommended for women 40-74 years of age. Among women ≥ 75 years of age, annual mammography screening should be reserved for those with an expected survival > 7 years. Complementary ultrasound should be considered for women with dense breasts. Complementary magnetic resonance imaging is recommended for women at high risk. When available, an advanced form of mammography known as tomosynthesis can be considered as a means of screening for breast cancer.

Resumo Objetivo: Apresentar as recomendações do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, da Sociedade Brasileira de Mastologia e da Federação Brasileira das Associações de Ginecologia e Obstetrícia para o rastreamento por imagem do câncer de mama no Brasil. Materiais e métodos: Foram analisados os estudos científicos disponíveis nas bases científicas Medline e Lilacs. Na ausência de dados probatórios, as recomendações refletiram o consenso da comissão de especialistas. Recomendações: O rastreamento mamográfico anual é recomendado para as mulheres entre 40 e 74 anos. Acima de 75 anos deve ser reservado para as mulheres que tenham expectativa de vida maior que 7 anos. O rastreamento complementar com ultrassonografia deve ser considerado para as mulheres com mamas densas. O rastreamento complementar com ressonância magnética é recomendado para as mulheres com alto risco. A tomossíntese é uma forma de mamografia que pode ser considerada para o rastreamento do câncer de mama, quando disponível.

RESUMO

Objective: To present the current breast cancer screening guidelines in Brazil, as devised by the Brazilian College of Radiology and Diagnostic Imaging (CBR), the Brazilian Society for Breast Disease (SBM) and the Brazilian Federation of Gynecological and Obstetrical Associations (FEBRASGO). Methods: We analyzed scientific studies available in Medline and Lilacs databases. In the absence of evidence, the guidelines reflected the consensus opinion of an expert panel. Guidelines: Annual mammography screening is recommended for women aged 40­74 years. Among women aged 75 years or older, annual mammography screening should be reserved for those with an expected survival of 7 years or more. Complementary ultrasound should be considered for women with dense breasts. Complementary magnetic resonance imaging is recommended for women at high risk. When available, an advanced form of mammography known as tomosynthesis can be considered as a means of screening for breast cancer.

Objetivo: Apresentar as recomendações do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), da Sociedade Brasileira de Mastologia (SBM) e da Federação Brasileira das Associações de Ginecologia e Obstetrícia (FEBRASGO) para o rastreamento por imagem do câncer de mama no Brasil. Métodos: Foram analisados os estudos disponíveis nas bases científicas Medline e Lilacs. Na ausência de dados probatórios, as recomendações refletiram o consenso da comissão de especialistas. Recomendações: O rastreamento mamográfico anual é recomendado para as mulheres entre 40 e 74 anos. Acima de 75 anos deve ser reservado para as mulheres que tenham expectativa de vida maior que 7 anos. O rastreamento complementar com ultrassonografia deve ser considerado para as mulheres com mamas densas. O rastreamento complementar com ressonância magnética é recomendado para as mulheres com alto risco. A tomossíntese é uma forma de mamografia que pode ser considerada para o rastreamento do câncer de mama, quando disponível.