Background/aim The Trento screening program transitioned to digital breast tomosynthesis (DBT) screening based on evidence that DBT improves breast cancer (BC) detection compared to mammography; an evaluation of the transition to DBT is reported in this pilot study. Methods Prospective implementation of DBT screening included women aged ≥50 years who attended the Trento program for biennial screening. DBT screening included DBT acquisitions with synthesized 2D-images. A historical cohort of women who attended the program (January 2013–October 2014) and received digital mammography (DM) provided a comparison group. Independent double-reading (with a third arbitrating read for discordance) was used for DBT and DM screening. Screening outcomes included cancer detection rate (CDR/1000 screens), percentage of screens recalled to assessment (recall%), interval cancer rate (ICR/1000 screens) at 2-year follow-up, and screening sensitivity. Rate ratios (RR) and 95% confidence interval (95%CI) examined outcomes for DBT versus DM screening. Results From women aged 50–69 years who accepted an invitation to screening (October 2014–October 2016) 46,343 comprised the DBT-screened group: amongst these 402 BCs (includes 50 ductal carcinoma in-situ (DCIS)) were detected (CDR 8.67/1000), whereas 205 BCs (includes 33 DCIS) were detected amongst 37,436 DM screens (CDR 5.48/1000) [RR for CDR:1.58 (1.34–1.87)]. Recall% was lower for DBT (2.55%) than DM (3.21%) [RR:0.79 (0.73–0.86)]. Compared to DM, DBT screening increased CDR for stage I-II BC, for all tumour size and grade categories, and for node-negative BC, but did not increase CDR for DCIS. Estimated ICR for DBT was 1.1/1000 whereas ICR for DM was 1.36/1000 [RR:0.81 (0.55–1.19)]. Screening sensitivity was 88.74% for DBT versus 80.08% for DM [RR:1.11 (0.94–1.31)]. Conclusion DBT significantly improved early-detection measures but did not significantly reduce ICR (relative to DM screening), suggesting that it could add benefit as well as adding over-detection in population BC screening.

Background: In the latest decades some compelling evidence confirmed the substantial benefits of using human milk, especially for preterm infants [1][2][3][4][5]. Donor human milk is a valid alternative.Objective: This survey aimed to evaluate the activity of the human milk banks in Italy, analysing several items. Methods: The Italian Association of Donor Human Milk Banks (Associazione Italiana Banche del Latte Umano Donato, AIBLUD) was founded in 2005. It currently consists of 35 human milk banks (Figure 1), whose management should follow the Italian Guidelines. Among the goals of the association, scientific work plays a major role. After publication of the Italian Guidelines, the 2012 survey on Italian human milk banks also led to a nationwide improvement: some banks were established, others that were considered inactive were shut down [11]. In 2013 the Italian Ministry of Health published the national recommendations, based on the Italian Guidelines [12].Results: 91% of the banks (32/35) responded to this second survey. Table 2 shows the average number of hours per week dedicated to the milk bank activity. This data varies greatly among the banks, as it did in 2012. The majority of the banks keeps having approximately 6 hours a day of work Conclusion:This second survey gave AIBLUD and the Italian Ministry of Health important information on the Italian human milk banks, overcoming their difficulties and correcting some negative aspects.