Mammographic screening reduces breast cancer mortality by 24% in women aged > or = 50 years. Women aged 50-53 are invited for their first screen in the National Health Service Breast Screening Programme (NHSBSP), thereafter at three-year intervals until the age of 64. Two-view mammography is offered at the first (prevalent) screening examination and one-view for subsequent (incident) screens. The screening films are sorted into either 'normal' or 'abnormal requiring further assessment'. Assessment is carried out by a specialist multidisciplinary team using the triple approach: clinical examination, imaging and, where appropriate, needle biopsy. Imaging is planned according to the mammographic abnormality--paddle compression view to assess parenchymal distortion, magnification view to assess microcalcification. After confirmation of a suspicious abnormality, needle biopsy is performed. Results of triple assessment are considered together by the multidisciplinary team and further management is planned. There are four likely outcomes: benign/normal, confirmed breast cancer, suspicious but needing diagnostic surgical excision, and diagnostic uncertainty needing early recall for screening.