Radiation risk of breast screening in England with digital mammography

Warren, Lucy M.; Dance, David R.; Young, Kenneth C.

doi:10.1259/bjr.20150897

Cited by 26 publications

(19 citation statements)

References 31 publications

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“…1), suggesting that they are more at risk compared to older patients (median age is 44.0 years). The mean tube voltage was comparable with previous studies and breast thickness (Baek et al, 2017, Warren et al, 2016, Hauge et al, 2014, Dance et al, 2009). The mean ESAK (mGy) and MDG (mGy) were 4.4 ± 1.1 and 1.1 ± 0.3, respectively.…”

Section: Resultssupporting

confidence: 89%

“…Mammographic image quality and MGD depend on imaging technique and the radiographic system used. The patient radiation dose per mammographic examination is lower compared to the previous published researches (Warren et al, 2016, Pasicz et al, 2016, Fartaria et al, 2016, Ślusarczyk-Kacprzyk et al, 2016, Soliman and Bakkari, 2015, Hauge et al, 2014, Al-Kafi et al, 2009, Dance et al, 2009, Smathers et al, 2007, Kruger and Schueler, 2001) (Fig. 2).…”

Section: Discussionmentioning

confidence: 55%

“…However, to diminish the risk of radiation induced malignant tumors, precise patient dose estimation and optimization are required to bring down the probability of breast cancer to its minimal value (EC, 1996). In the literature, the mean glandular dose (MGD) ranged between 2.0 and 3.7 mGy per procedure (Warren et al, 2016, Pasicz et al, 2016, Fartaria et al, 2016, Ślusarczyk-Kacprzyk et al, 2016, Soliman and Bakkari, 2015, Hauge et al, 2014, Al-Kafi et al, 2009). Although, evaluation of patients' ionizing radiation exposures from radiodiagnostic examinations is recommended for dose optimization and benefit/risk evaluation, few studies have been published regarding patient doses during mammography in Saudi Arabia (Soliman and Bakkari, 2015, Al-Kafi et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

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Estimation of cancer risks during mammography procedure in Saudi Arabia

Sulieman

Serhan

Al-Mohammed

et al. 2019

Saudi Journal of Biological Sciences

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The aims of the present work were to quantify radiation doses arises from patients' exposure in mammographic X-ray imaging procedures and to estimate the radiation induced cancer risk. Sixty patients were evaluated using a calibrated digital mammography unit at King Khaled Hospital and Prince Sultan Center, Alkharj, Saudi Arabia. The average patient age (years) was 44.4 ± 10 (26–69). The average and range of exposure parameters were 29.1 ± 1.9 (24.0–33.0) and 78.4 ± 17.5 (28.0–173.0) for X-ray tube potential (kVp) and current multiplied by the exposure time (s) (mAs), respectively. The MGD (mGy) per single projection for craniocaudal (CC), Medio lateral oblique (MLO) and lateromedial (LM) was 1.02 ± 0.2 (0.4–1.8), 1.1 ± 0.3 (0.5–1.8), 1.1 ± 0.3 (0.5–1.9) per procedure, in that order. The average cancer risk per projection is 177 per million procedures. The cancer risk is significant during multiple image acquisition. The study revealed that 80% of the procedures with normal findings. However, precise justification is required especially for young patients.

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Section: Resultssupporting

confidence: 89%

Section: Discussionmentioning

confidence: 55%

Section: Introductionmentioning

confidence: 99%

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Estimation of cancer risks during mammography procedure in Saudi Arabia

Sulieman

Serhan

Al-Mohammed

et al. 2019

Saudi Journal of Biological Sciences

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“…The impact of overdiagnosis on radiation exposure is extremely difficult to estimate. It has been evaluated that the mean glandular dose for screening mammography ranges between 3 and 10 mGy and it is mainly influenced by the number of views acquired, the technology used and by patient-related factors [57,58]. Despite the radiation exposure level, it has been demonstrated that the number of deaths caused by radiation-induced cancers is around 125-208 time smaller than the lives saved owing to screening [58,59].…”

Section: Discussionmentioning

confidence: 99%

Overdiagnosis and overimaging: an ethical issue for radiological protection

et al. 2019

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Aims and objectives This study aimed to analyse the key factors that influence the overimaging using X-ray such as selfreferral, defensive medicine and duplicate imaging studies and to emphasize the ethical problem that derives from it. Materials and methods In this study, we focused on the more frequent sources of overdiagnosis such as the total-body CT, proposed in the form of screening in both public and private sector, the choice of the most sensitive test for each pathology such as pulmonary embolism, ultrasound investigations mostly of the thyroid and of the prostate and MR examinations, especially of the musculoskeletal system. Results The direct follow of overdiagnosis and overimaging is the increase in the risk of contrast media infusion, radiant damage, and costs in the worldwide healthcare system. The theme of the costs of overdiagnosis is strongly related to inappropriate or poorly appropriate imaging examination. Conclusions We underline the ethical imperatives of trust and right conduct, because the major ethical problems in radiology emerge in the justification of medical exposures of patients in the practice. A close cooperation and collaboration across all the physicians responsible for patient care in requiring imaging examination is also important, balancing possible ionizing radiation disadvantages and patient benefits in terms of care.

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“…The exposure from mammography poses an additional risk to induce tumors by ionizing radiation. Several papers have examined and estimated the risk arising from such screening programs and compared with the benefit 2–4 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of a personalized breast dosimetry method with standard dosimetry protocols

Salomon

Homolka

Semturs

et al. 2019

Sci Rep

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Average glandular dose (AGD) in digital mammography crucially depends on the estimation of breast glandularity. In this study we compared three different methods of estimating glandularities according to Wu, Dance and Volpara with respect to resulting AGDs. Exposure data from 3050 patient images, acquired with a GE Senographe Essential constituted the study population of this work. We compared AGD (1) according to Dance et al . applying custom g, c, and s factors using HVL, breast thickness, patient age and incident air kerma (IAK) from the DICOM headers; (2) according to Wu et al . as determined by the GE system; and (3) AGD derived with the Dance model with personalized c factors using glandularity determined with the Volpara (Volpara Solutions, Wellington, New Zealand) software (Volpare AGD). The ratios of the resulting AGDs were analysed versus parameters influencing dose. The highest deviation between the resulting AGDs was found in the ratio of GE AGD to Volpara AGD for breast thicknesses between 20 and 40 mm (ratio: 0.80). For thicker breasts this ratio is close to one (1 ± 0.02 for breast thicknesses >60 mm). The Dance to Volpara ratio was between 0.86 (breast thickness 20–40 mm) and 0.99 (>80 mm), and Dance/GE AGD was between 1.07 (breast thickness 20–40 mm) and 0.98 (41–60, and >80 mm). Glandularities by Volpara were generally smaller than the one calculated with the Dance method. This effect is most pronounced for small breast thickness and older ages. Taking the considerable divergences between the AGDs from different methods into account, the selection of the method should by done carefully. As the Volpara method provides an analysis of the individual breast tissue, while the Wu and the Dance methods use look up tables and custom parameter sets, the Volpara method might be more appropriate if individual ADG values are sought. For regulatory purposes and comparison with diagnostic reference values, the method to be used needs to be defined exactly and clearly be stated. However, it should be accepted that dose values calculated with standardized models, like AGD and also effective dose, are afflicted with a considerable uncertainty budgets that need to be accounted for in the interpretation of these values.

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Radiation risk of breast screening in England with digital mammography

Cited by 26 publications

References 31 publications

Estimation of cancer risks during mammography procedure in Saudi Arabia

Estimation of cancer risks during mammography procedure in Saudi Arabia

Overdiagnosis and overimaging: an ethical issue for radiological protection

Comparison of a personalized breast dosimetry method with standard dosimetry protocols

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