Primary prevention of breast cancer as well as for other malignancies is hardly accomplishable and still only finds limited acceptance in the population. Therefore, secondary prevention is so much more important. The diagnostic options used in early detection have made distinct progress. Therefore, diagnostics as well as treatment have been improved. Digital mammography is now the standard in clinical as well as in screening mammography. Moreover, it also offers further options, such as tomosynthesis and the use of CAD systems. Prospectively, these new options will influence the senological diagnostics in early detection. Regular general screening for women aged between 50 and 69 years old and intensified monitoring of women with a family history of breast cancer has recently been introduced in Germany. Results are expected at the end of the year. Available data suggest that implementation of a general mammography screening can reduce the mortality of breast cancer by about 25%.