[Summary of the practice guideline 'Diagnosis of breast cancer' (second revision) from the Dutch College of General Practitioners].

Breast cancer is the most prevalent malignancy among Dutch women; life prevalence is about 10%. A tumour in the breast of a woman of 35 years or older is always an indication for mammography, while a woman younger than 35 should have an ultrasound investigation. This is also the case if the woman can feel the tumour but the doctor is unable to. In breast pain without palpable abnormalities at physical examination, the risk of breast cancer is a lot lower and diagnostics may not need to be instigated immediately. However, persistent localized pain is an indication for breast imaging. Women with at least a doubled risk of getting breast cancer due to the occurrence of breast cancer in their relatives are recommended to undergo mammography every year from the ages of 40-49 years supplementary to the national screening programme. The Dutch national screening programme invites women aged between 50 and 75 to undergo mammography every two years. Follow-up of women of 60 years and older treated by lumpectomy 5 years or more previously, can be done by the general practitioner.