Routine Screening Mammography: how Important is the Radiation-Risk Side of Benefit-Risk Equation?

Low doses of low-energy X-rays produce an increased risk per unit dose of about a factor of 2

Abstract:

Routine screening mammography: how important is the radiation-risk side of the benefit-risk equation?
There is evidence that low-energy X-rays as used in mammographic screening produce an increased biological risk per unit dose relative to higher-energy photons.

The potential radiation hazards associated with routine screening mammography, in terms of breast cancer induction, are discussed in the context of the potential benefits. The very low energy X-rays used in screening mammography (26-30 kVp) are expected to be more hazardous, per unit dose, than high-energy X- or gamma-rays, such as those to which A-bomb survivors (from which radiation risk estimates are derived) were exposed. Based on in vitro studies using oncogenic transformation and chromosome aberration end-points, as well as theoretical estimates, it seems likely that low doses of low-energy X-rays produce an increased risk per unit dose (compared with high energy photons) of about a factor of 2. Because of the low doses involved in screening mammography, the benefit-risk ratio for older women would still be expected to be large, though for younger women the increase in the estimated radiation risk suggests a somewhat later age than currently recommended–by about 5-10 years–at which to commence routine breast screening.

Sources: NCBI, PMID: 12556334
Int J Radiat Biol. 2002 Dec;78(12):1065-7.

Full Article:

Routine screening mammography: how important is the radiation-risk side of the benefit-risk equation? CEM, int. j. radiat. biol 2002, vol. 78, no. 12.

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