Understanding the risk of ionizing radiation in breast imaging: Concepts and quantities, clinical importance, and future directions

Eur J Radiol. 2024 Dec:181:111784. doi: 10.1016/j.ejrad.2024.111784. Epub 2024 Oct 12.

Abstract

Background: Conventional mammography remains the primary imaging modality for state-of-the-art breast imaging practice and its benefit (both on diagnostic and screening) was largely reported. In mammography, the typical Mean Glandular Dose (MGD) from X-ray radiation to the breast spans, on average, from 1 to 10 mGy, depending on breast thicknesses, percentage of fibroglandular tissue, and on the examination purpose.

Methods: The aim of this narrative review is to describe the extent of radiation risk in X-ray breast imaging and discuss the main steps and parameters (e.g. MGD, screening frequency and number of examination views) that may have an influence on the radiation risk assessment.

Results: Even though the radiation doses used with these examinations are very low, as compared to other medical or natural radiation exposures, there is a non-negligible associated risk of radiation-induced cancer. Accurate radiation risk assessment permits to better balance the overall estimation of the benefit-to-risk ratio in X-ray breast imaging.

Conclusions: It is expected that a better knowledge about radiation-induced cancer risk among population could improve the communications skills between patients and clinicians and could help to increase the awareness in women about radiation risk perception for a transparent and proper informed choice of imaging exam.

Keywords: Absorbed dose; Low doses; Mammography; Radiation-induced cancer risk.

Publication types

  • Review

MeSH terms

  • Breast Neoplasms* / diagnostic imaging
  • Clinical Relevance
  • Female
  • Humans
  • Mammography* / methods
  • Neoplasms, Radiation-Induced / diagnostic imaging
  • Neoplasms, Radiation-Induced / etiology
  • Radiation Dosage*
  • Radiation Protection / methods
  • Radiation, Ionizing
  • Risk Assessment
  • Risk Factors