Position paper on screening for breast cancer by the European Society of Breast Imaging (EUSOBI) and 30 national breast radiology bodies from Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Israel, Lithuania, Moldova, The Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Spain, Sweden, Switzerland and Turkey.

EUSOBI and 30 national breast radiology bodies support mammography for population-based screening, demonstrated to reduce breast cancer (BC) mortality and treatment impact. According to the International Agency for Research on Cancer, the reduction in mortality is 40 % for women aged 50-69 years taking up the invitation while the probability of false-positive needle biopsy is <1 % per round and overdiagnosis is only 1-10 % for a 20-year screening. Mortality reduction was also observed for the age groups 40-49 years and 70-74 years, although with "limited evidence". Thus, we firstly recommend biennial screening mammography for average-risk women aged 50-69 years; extension up to 73 or 75 years, biennially, is a second priority, from 40-45 to 49 years, annually, a third priority. Screening with thermography or other optical tools as alternatives to mammography is discouraged. Preference should be given to population screening programmes on a territorial basis, with double reading. Adoption of digital mammography (not film-screen or phosphor-plate computer radiography) is a priority, which also improves sensitivity in dense breasts. Radiologists qualified as screening readers should be involved in programmes. Digital breast tomosynthesis is also set to become "routine mammography" in the screening setting in the next future. Dedicated pathways for high-risk women offering breast MRI according to national or international guidelines and recommendations are encouraged. KEY POINTS: • EUSOBI and 30 national breast radiology bodies support screening mammography. • A first priority is double-reading biennial mammography for women aged 50-69 years. • Extension to 73-75 and from 40-45 to 49 years is also encouraged. • Digital mammography (not film-screen or computer radiography) should be used. • DBT is set to become "routine mammography" in the screening setting in the next future.

Male Malignant Phyllodes Breast Tumor After Prophylactic Breast Radiotherapy and Bicalutamide Treatment: A Case Report.

Phyllodes tumor in male breast is an exceptionally rare neoplasm with only few published case reports. Herein, we present a case of malignant phyllodes tumor in male breast nine years after prophylactic breast 10 Gy radiotherapy and after nine year bicalutamide treatment. The imaging findings of the tumor and pathological correlation are also presented.

Breast sonography in localizing the cause of nipple discharge: comparison with galactography in 52 patients.

OBJECTIVE: The purpose of this study was to evaluate breast sonography in localizing abnormalities in the discharging duct in patients with spontaneous nipple discharge. METHODS: Fifty-two patients with unilateral bloody or serous nipple discharge and normal findings on palpation and mammography underwent breast sonography before surgical duct excision. The results of sonography were compared with the findings of galactography and histologic examination of the surgical specimen. RESULTS: The final diagnosis was benign in 47 cases (90%) and malignant in 5 cases (10%). Sonography visualized an echogenic intraductal tumor in 36 (69%) of 52 cases, dilated duct(s) without an intraductal tumor in 6 cases (12%), and no abnormality in 10 cases (19%). Eighty percent of papillomatous lesions, 58% of other benign lesions, and 20% of malignant lesions were sonographically positive. The abnormal duct was surgically removed after methylene blue staining in 38 cases, after sonographically guided wire localization in 11 cases, after both wire localization and methylene blue staining in 1 case, and with review of the diagnostic galactographic images in 2 cases. CONCLUSIONS: Sonography was found to be a valuable method for localizing intraductal abnormalities, especially papillomatous lesions, in patients with nipple discharge with no other clinical or radiologic findings. Preoperative sonographically guided wire localization can be used successfully instead of conventional methylene blue staining in cases with problems in cannulation of the discharging duct. Galactography remains the primary diagnostic method, especially in depicting malignant causes of nipple discharge, which may be seen only as duct dilatation on sonography.

Low-field versus high-field MRI in diagnosing breast disorders.

We evaluated the performance of low-field MRI in breast disorders by comparing it with high-field MRI and biopsy results. Twenty-eight consecutive patients who were able to undergo two magnetic resonance examinations on following days were examined by high-field and low-field MRI. After T1-weighted sagittal images had been obtained a dynamic 3D axial study was performed followed by the acquisition of contrast-enhanced T1-weighted sagittal images. The images were analyzed separately by two radiologists paying attention to lesion morphology and enhancement kinetics. Six patients had problems in both breasts (34 breasts studied). The results were compared with biopsy results of 27 breasts. There were 16 malignant lesions, two fibroadenomas and nine other benign lesions. The inter-magnetic-resonance-scanner kappa value was 0.77 (substantial agreement), while the interobserver kappa value was 0.86 and 0.81 at low and high field, respectively (excellent agreement). The sensitivity was 100 and 100%, the specificity was 82 and 73% and the accuracy was 93 and 89% at low and high field, respectively. The mean lesion size was 2 cm and the smallest malignant lesion was 8 mm in diameter. Low-field MRI is a promising tool for breast imaging. Larger materials and smaller lesions are needed to evaluate its true sensitivity and specificity.

General practitioner's skills to perform limited goal-oriented abdominal US examinations after one month of intensive training.

A training program of "limited goal-oriented abdominal sonography" for general practitioners (GPs) was planned, set up and tested. After 1 month of intensive training (about 100 examinations), four test subjects succeeded in technically performing examinations in four patients out of five patients, and were able to rule out or exclude fluid collections, aortic aneurysms and common gallbladder disease.