Early detection of breast cancer is only successful if the whole diagnostic process takes place within a comprehensive quality management programme. Results of eight international randomized screening studies and meta-analyses confirmed a breast cancer mortality reduction. Comparable effects of increased breast cancer incidence and a more favourable tumour stage distribution could also be shown within a pilot project on quality assurance of breast cancer diagnostics and assessment in Schleswig-Holstein compared to regular care. Mammography screening is therefore indispensable and very welcome in our state. However, the exact form and manner in which this should be implemented, with respect to our specific health care structure, has to be discussed and changed. Our aim should be to join together the multidisciplinary expertise now available in many certified breast centres with the expertise of the diagnostic process, whether it be screening or so-called therapeutic care, into a structural whole.