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.

Invasive apocrine carcinoma (IAC) of the breast is a rare primary breast cancer constituting~4% of all breast cancers. 1 Mammary apocrine epithelium exhibits a characteristic steroid receptor profile that is negative for estrogen receptor (ER) and positive for androgen receptor (AR). 2 Obtaining ER-/AR+profile is required to qualify IAC as "pure" (PAC). 2,3 Previous molecular studies indicated poor prognostic signatures of IAC. 4,5 Clinical outcome of IAC remains contradictory as most studies recruited a small number of patients and have not used well-defined criteria for IAC. 2,6 We evaluated a cohort of 62 IAC patients (33 PAC [53%] and 29 ALC [47%]) among~3000 breast cancers diagnosed at author's affiliated hospital (incidencẽ 2%). IACs were diagnosed at an older age, higher stage and grade (Table 1). Zhang et al also found that IACs are more prevalent among older patients and tend to be of higher histologic grade compared with NST carcinomas. 6 Seventeen patients (12 patients with follow-up data) were treated with neoadjuvant therapy (Table 2). Four patients (33%) achieved a pCR, two patients (16%) had Pr, while six patients (50%) had CrT. Interestingly, four of six CrTs, despite Her2 positivity, were not treated with anti-HER2 therapy. In the entire cohort, only one third of the Her2+ patients received T A B L E 1 Clinicopathologic characteristics of the apocrine cohort Characteristic IAC (n = 62) PAC vs ALC P-value Median follow-up (mo, range) 45.5 (2-136) 0.534 Age at diagnosis (y, mean/range) 59.5 (37-88) 0.943 Age groups <49 13 >50 49 Grade 2 28 (45.1%) 0.237 3 34 (54.8%) Tumor size (cm) ≤2 12 (19.4%) 0.311 >2 and ≤5 34 (54.8%) >5 16 (25.8%) (Continues)

Glycogen-rich clear cell carcinoma (GRCC) is a very rare form of primary breast cancer (< 0.1% of all breast cancers). It is characterized by the presence of neoplastic cells with a glycogen-abundant clear cytoplasm (the Periodic Acid Schiffpositive, diastase-sensitive). The expression of steroid receptors (estrogen and progesterone receptors) has been variably reported (35% to 100% of the cases), whereas most studies reported low human epidermal growth factor receptor 2 positivity in GRCC. High androgen receptor positivity without androgen receptor splice variant-7 was reported in one recent study. Although sparse, the preliminary theranostic data on GRCC indicate the potential of targeted treatments in selected cases (antiandrogen, PIK3CA, and immune checkpoint inhibitors). Because of its rarity, the prognosis for GRCC patients remains controversial. Herein, we comprehensively appraise the epidemiological, morphologic, molecular, and clinical characteristics of this rare mammary malignancy.