Effective lifetime radiation risk for a number of national mammography screening programmes

Abstract

Keywords:Breast screening Effective risk FFDM MGD Thermoluminescence dosimetry a b s t r a c t Background and purpose: The performance of mammography screening programmes is focussed mainly on breast cancer detection rates. However, when the benefits and risks of mammography are considered, the risk of radiation-induced cancer is calculated for only the examined breast using Mean Glandular Dose (MGD). The risk from radiation during mammography is often described as low or minimal. This study aims to evaluate the effective lifetime risk from full field digital mammography (FFDM) for a number of national screening programmes. Material and Methods: Using an ATOM phantom, radiation doses to multiple organs were measured during standard screening mammography. Sixteen FFDM machines were used and the effective lifetime risk was calculated across the female lifespan for each machine. Once the risks were calculated using the phantom, the total effective lifetime risk across 48 national screening programmes was then calculated; this assumed that all these programmes use FFDM for screening. Breast cancer morbidity differs significantly between regions and according to the American Cancer Society (ACS), 3 39% of breast cancer cases were recorded in Asia while in Europe and North America, the figures were 28% and 15%, respectively. Early diagnosis and treatment of breast cancer is the key to reduce mortality. 4Randomised screening trials using mammography illustrated that screening can reduce breast cancer mortality by 15e20%. 5 Since mammography is seen as a cost-effective technique for early detection of breast cancer, it remains the recommended modality for both screening and diagnosis. The performance of any screening programme should be assessed by three parameters; sensitivity, specificity, and positive predictive value. 7,8 The calculation of these parameters depends on three related quantities; mammography false negatives which represents mammography's inability to detect all breast cancers, mammography false positives which may result in extra examinations and undesired anxiety for women, and overdiagnosis of low risk breast cancers that may never cause health problems.9,10

Comparison of Abbreviated Breast MRI vs Digital Breast Tomosynthesis for Breast Cancer Detection Among Women With Dense Breasts Undergoing Screening

“…12,14,30,32,33 Future studies are necessary to determine whether AB-MR alone could be used to screen women with dense breasts, given that mammography/DBT would add additional cost and exposure to ionizing radiation with no or limited added benefit. 34 Uniformity across study sites was established by standardizing the AB-MR protocol and the contrast agent used (Multihance), and by providing the Society of Breast MRI interpretation algorithms. As a result, despite the fact that 47 of the 48 participating sites did not have prior practical experience with AB-MR, the cancer-detection-rate was similar to levels published by skilled MRI practices on full-protocol MRI, 10-13;30-33 and the PPV of AB-MR did not differ significantly from that of DBT.…”

Social Relationships, Age and the Use of Preventive Health Services: Findings from the German Ageing Survey

“…Besides methodological limitations, there is an ongoing debate on the effectiveness or harmfulness of preventive health services, especially, concerning cancer screenings and flu vaccination [64,65,66]. It is important to keep that in mind, when discussing the use of preventive health services in general.…”

“…Kwok stated that “vaccines do carry risks, ranging from rashes or tenderness at the site of injection to fever-associated seizures […] and dangerous infections in those with compromised immune systems” [67], although severe complications are unusual and it is difficult to show that a vaccine is the cause for them [67]. With regard to the controversy over cancer screenings, radiation risks are one part of it [64]. The controversy also includes arguments on over-treatment and over-diagnosis of cancer.…”

Opportunities for Early Cancer Detection: The Rise of ctDNA Methylation-Based Pan-Cancer Screening Technologies

“…Moreover, some of the conventional screening methods such as optical colonoscopy or cervical cytology testing can involve invasive procedures that could cause discomfort and, in some cases, complications [ 29 , 30 ]. Other methodologies exposing patient’s body to radiation such as CT scan or mammography could also come with potential risk when undergoing repeated testing [ 31 , 32 ]. The emergence of minimally invasive methodologies such as blood, urine, or stool-based testing are of promising avenue to reduce invasiveness and risk, as well as facilitate uptake and repeated testing in screening settings.…”