The use of mammographic screening to detect breast cancer at a preclinical stage is increasing rapidly in the United States. High-quality imaging and accurate interpretation are critical elements for successful mortality reduction. The communication of the interpretation is being scrutinized in an effort to eliminate ambiguity and confusion. This can be accomplished by an organized approach to interpretation and a structured analysis of significant findings. These can be grouped into five major categories ranging from a negative examination to findings suggesting a very high probability of malignancy. A concisely organized reporting system is to be proposed by committees of the ACR that will provide clinically relevant information. The system will suggest the use of an approved vocabulary and urge that significant findings be described concisely in a standardized format. All studies should be categorized using the five clinically useful assessment groups. This combined with the maintenance of a data base for determining results will improve the accuracy of the screening effort, permit the monitoring of the screening results, and provide feedback for improving the program.