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As prerequisite conditions for DBT adoption, the panel defines a full extension to women in the 45\u221274 age range, sufficient technical and professional resources, and an adequate monitoring system. The panel recommends the use of either DBT or digital mammography (DM) for asymptomatic women participating in organized screening programmes. However, it suggests prioritizing DBT in women with high mammographic breast density(classified as BI-RADS class\n                    <jats:italic>c<\/jats:italic>\n                    or\n                    <jats:italic>d<\/jats:italic>\n                    ) when density has been previously assessed with DM. In the case of limited resources, priority in the implementation should be given to women with extremely dense breasts (BI-RADS class\n                    <jats:italic>d<\/jats:italic>\n                    ). The use of DBT as an additional screening tool alongside DM is not recommended. These guidelines aim to provide a tailored approach for screening women with high mammographic breast density, improving detection while optimizing resource allocation in the context of organized screening. However, these recommendations also apply to the setting of spontaneous screening.\n                  <\/jats:p>","DOI":"10.1007\/s11547-026-02186-0","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T08:27:05Z","timestamp":1772699225000},"page":"937-950","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Italian guidelines for the use of digital breast tomosynthesis in breast cancer screening programmes: GRADE-ADOLOPMENT of the European 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Marco Rosselli Del Turco is a former medical consultant for senology to the FORA s.p.a. Paolo Giorgi Rossi and Livia Giordano are members of the panel that developed the European guidelines on breast cancer screening and diagnosis, which is the reference document for the ADOLOPMENT process. Vittorio Cannat\u00e0 is a former Vice-President of the Italian Association of Medical Physics (AIFM). Isabella Castellano has been a professional consultant for the \u201cChoosing the best therapy in ER\u2009+\u2009\/HER2- breast cancer\u201d symposium (token of attendance at the National Congress of Anatomic Pathology, October 2019), Myriad Genetics, s.r.l. Stefano Pacifici is President of the Italian Association of Senology Radiographers (AITeRS). Annalisa Trianni is member of the Italian Association of Medical Physics (AIFM). Paola Golinelli was reimbursed for participation in the European Federation of Organization for Medical Physics (EFOMP) Working Group on mammographic tomosynthesis equipment. The other authors have no relevant financial or non-financial interest to disclose. Gian Paolo Morgano is a contract staff member at the Joint Research Centre (JRC) of the European Commission, Ispra, VA (Italy). All panellists were required to disclose all financial, non-financial, personal, and institutional interests relevant to the scope of the guidelines by completing a standardized form, following the guidance from the guidance from the SNLG. The Scientific Committee assessed each individual interest, and ultimately, no panellist was excluded from the voting procedures. This policy was upheld throughout the entire process, including the selection of panel members, the generation and prioritization of research questions, and participation in the formulation of recommendations. The Scientific Committee consistently monitored the declaration of conflicts of interest. Francesco Sardanelli reports sponsored talks or ad hocadvisory board participation for Bayer Healthcare, Bracco Group, GE Healthcare, and Siemens Healthineers as well as research grants from Bayer Healthcare, Bracco Group, and GE Healthcare; in addition, he is the Scientific PI ofthe BreastSCan project (Pan-European Breast Image Platform for Advanced AI-based Breast Cancer Screening),funded by the European Commission under the EU4Health Programme.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}