Abstract
Background: The aim of this study was to review the roleof the pathologist in mammography screening. Patientsand Methods: The first German mammography screeningproject was undertaken in Bremen in June 2001.Women between the ages of 50 and 69 were offeredmammographic assessment. Suspicious findings werefollowed up by a stereotactic core biopsy or vacuum-assistedcore biopsy. The tissue was examined at the Departmentof Pathology in Bremen as well as at the Sectionof Breast Pathology at the University Münster. Eachcase was discussed in a multidisciplinary board. Thecore biopsies were classified according to the 5-pointscale of the internationial guidelines. Results: Biopsieswere obtained from 402 women within the first 2 yearsof the screening project. Of these, 47% were assigned togroup B5 (malignant), 44% were categorized in group B2(benign) while 1% was classified in group B1 (regularbreast tissue, unsatisfactory) and 8% were assigned tothe group B3/B4 (lesion of uncertain malignant potential /suspicious for malignancy). The discrepancies in 10% ofthe cases centered on papillary lesions, flat epithelialatypia (FEA) and atypical ductal hyperplasia (ADH). Conclusion:In clearly defined lesions the agreement of thehistological findings of independent pathologists is veryhigh. In unclear lesions it should be raised. In addition,close cooperation between clinicians, radiologists andpathologists is critical.
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