Perspective of the role of radiologists on diagnosis and treatment of ductal carcinoma in situ of the breast

In Japan, surgeons, gynecologists and general practitioners other than radiologists have long been involved in breast cancer screening program using clinical breast examination that is quite different from screening mammography conducted in the western countries. We generated the guidelines for quality control in mammography screening in 2000. High quality is required for mammography screening to ensure not only mortality reduction from breast cancer, but also protection from radiation risk. The key organizational aspects include; identification of target population with screening age groups and intervals, mammography facilities that will be involved, minimum QC test frequencies, trainings for radiographers and interpreting physicians, screening examination processes, and reporting system. Screening facility should qualify the guidelines of the Japan Radiological Society, also is required to have sufficient image quality using phantom image and average glandular dose. Mammography as a screening test for breast cancer has to meet stringent quality requirements, which must include the role of the radiologists. As breast cancer incidence increases in Japan, the role of radiologists becomes more important at the every step of diagnosis and treatment of ductal carcinoma in situ of the breast.