Mammography

Mammography is low-dose X-ray imaging of the breast (effective dose roughly 0.4 mSv per bilateral two-view study) and is the only modality with randomised-trial evidence for reducing breast-cancer mortality. The 2024 USPSTF recommendation (Grade B) advises biennial screening for women aged 40–74, lowered from age 50, citing CISNET modelling that earlier initiation reduces mortality and narrows racial disparities. Evidence for screening women aged 75 and older, and for supplemental ultrasound or MRI in dense breasts (BI-RADS C/D), remains Grade I (insufficient). The German Mammographie-Screening-Programm offers biennial screening to women aged 50–75 (the upper limit was raised from 69 to 75 on 1 July 2024 following a G-BA/IQWiG benefit assessment). Harms include false positives, overdiagnosis (particularly DCIS) and radiation-induced cancer at very low absolute risk.