Risk factors for induction of breast cancer by X-rays and their implications for breast screening

Abstract

In order to discuss the balance of benefit and radiation risk in a breast screening programme, it is necessary to have numerical values for the probability of breast cancer induction by X-rays, stratified by age. Various sets of such values have been used hitherto, mainly in relation to breast screening in the UK, both within the NHS Screening Programme and more generally for younger age groups. Further sets have recently been reported. These different sets of values are described and discussed, together with the effects of using additive or relative risk models, and the effect of using a dose and dose rate modifying factor (DDREF). Possible new radiation risk factors for breast cancer induction by X-rays, drawn from these sets, are identified. These are used to calculate fresh values of cancer detection/induction ratios, as an index of benefit/risk, for screening age women and for younger women with and without a family history of breast cancer.

The TOMMY trial: a comparison of TOMosynthesis with digital MammographY in the UK NHS Breast Screening Programme – a multicentre retrospective reading study comparing the diagnostic performance of digital breast tomosynthesis and digital mammography with digital mammography alone

“…82,83 For this trial, the total MGD was estimated at 7 mGy (Table 1), giving rise to an estimated 1 in 10,000 risk of cancer induction (assuming an induction rate of 14 per million per mGy). In practice, some of this dose would have been received during normal assessment procedures (estimated at 1.5 to 3.0 mGy depending on local practice); therefore the additional dose ranged from 4.0 to 5.5 mGy.…”

Education for Radiological Technologists and Their Place in Mammography Diagnostic Methods

“…MRI is more a significant diagnostic method, , but there is a higher cost for this type of examination (Berrington de Gonzalez & Reeves, 2005;Kriege et al, 2004;MARIBS Study Group, 2006). Mammography, like MRI, has a dose of radiation, and for this reason has special protocols for screening (Law & Faulkner, 2001;Law, Faulkner, & Young, 2007;Mattsson & Rutquvist, 2000). Patients with low risk are screened with sonography, which can be done by doctors of different specialties (Law & Faulkner, 2002).…”

No strong evidence for increased risk of breast cancer 8–26 years after multiple mammograms in their 30s in females at moderate and high familial risk

“…8 Using this definition, mammography was deemed potentially beneficial in females aged 30-39 years at moderate risk with a mother or sister with breast cancer in their 30s but is more marginal in females aged 30-34 years with a mother or sister with breast cancer in their 40s. 8 In keeping with the National Institute for Health and Care Excellence guidance, 6 the ratios drop markedly below 30 years of age and mammography was not recommended.…”

“…8 Using this definition, mammography was deemed potentially beneficial in females aged 30-39 years at moderate risk with a mother or sister with breast cancer in their 30s but is more marginal in females aged 30-34 years with a mother or sister with breast cancer in their 40s. 8 In keeping with the National Institute for Health and Care Excellence guidance, 6 the ratios drop markedly below 30 years of age and mammography was not recommended. [6][7][8][9] To assess the effect of mammography alone, we have examined potential breast cancer induction in females exposed to $5 mammograms starting before 37 years of age compared with females exposed at least 10 years later.…”

“…8 In keeping with the National Institute for Health and Care Excellence guidance, 6 the ratios drop markedly below 30 years of age and mammography was not recommended. [6][7][8][9] To assess the effect of mammography alone, we have examined potential breast cancer induction in females exposed to $5 mammograms starting before 37 years of age compared with females exposed at least 10 years later.…”