Cancers detected and induced in mammographic screening: new screening schedules and younger women with family history.

Abstract

The numbers of cancers detected and induced in breast screening programmes are examined for two-view screening, and for a 2 year screening interval, in contrast to the single view screening at a 3 year interval of the UK Breast Screening Programme up until early 1995. Two-view screening is also considered for the 1 year interval and age range of the current UK age trial (40-47 years). The corresponding figures for screening of groups having a family history of breast cancer are calculated and discussed. Breast cancer induction data are taken from National Radiological Protection Board publications. Cancer detection rates are based on observed rates where available, and calculated rates otherwise. The results of calculations indicate cause for concern if screening is to be extended below the age of 30 years (or below 35 years in certain categories), or below 40 years of age if family history groups are shown in the future to have a generally increased susceptibility to ionizing radiation. The importance of restricting dose to 2 mGy per film (mean glandular dose for a standard breast thickness of 4.5 cm) is stressed, together with the need ot maintain maximum image quality. This is especially true for the family history groups, who should only be screened in centres within established screening programmes, or in centres with equally strict quality control procedures.

Breast MR imaging in women at high-risk of breast cancer. Is something changing in early breast cancer detection?

“…Importantly, BRCA1 and BRCA2 mutation carriers are probably more sensitive to ionizing radiation [90,91], as demonstrated for BRCA2 in an animal model [92]. We have no evidence of cancers directly induced by radiation exposure within the mammographic range.…”

“…In addition, the risk of cancer induction by mammography in high-risk women is not negligible [2, [90][91][92][93], as stated above. In high-risk women, in particular BRCA mutation carries, a more favorable risk-benefit balance could be obtained using a single-view (medio-lateral oblique) approach instead of standard two-view, avoiding 50% of radiation exposure.…”

Breast carcinoma in women previously treated for Hodgkin's disease: clinical and mammographic findings

“…Breast cancer induction data, taken from National Radiological Protection Board publications, indicate the importance of restricting dose to 2 mGy per film if screening is to be extended below the age of 30 years. In analogy, the patient population should only be surveyed in centers with strict quality-control procedures [32]. Ultrasonography could be a useful adjunct to analyze abnormal clinical findings overlooked at mammography and breast tissue exposed to radiation which is not well depicted on mammograms (axillary tail, inner quadrants, upper parts; Fig.…”

Breast Cancer Screening, Outside the Population-Screening Program, of Women from Breast Cancer Families without Proven BRCA1/BRCA2 Mutations: a Simulation Study

“…A MEDLINE search was done to find information on the risk of tumor induction due to radiation in women at increased risk of breast cancer. We (28,(54)(55)(56)(57). These studies showed that women who are susceptible to breast cancer due to a genetic mutation are at higher risk of radiation-induced breast cancer than women who do not carry such a mutation.…”