STUDY: Mammography with Implants Increases Radiation Induced Breast Cancer to Unacceptable Level

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AJR Am J Roentgenol. 2007 May;188(5):1414-21.

EXCERPT: Mean glandular dose per breast from four-view augmentation
mammography with the 100-speed screen-film and Mo-Mo target-filter
combinations averaged 10.7 mGy, which is 3.1 times higher than the 3.4
mGy for conventional two-view mammography of breasts without implants.

In 40 years of screening, this number represents a more than tripled
lifetime attributable risk of radiation-induced breast cancer-an
unacceptable level.


Radiation dose reduction for augmentation mammography.Smathers RL,
Boone JM, Lee LJ, Berns EA, Miller RA, Wright AM.
Mammography Specialists Medical Group, Inc., 14651 S Bascom Ave.,
Suite 210, Los Gatos, CA 95032.

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_DocSum

OBJECTIVE: Patients who undergo cosmetic augmentation have larger and
denser breasts and receive higher radiation doses during mammography
than women without implants. In this study we evaluated the dose
increase and techniques for dose reduction.

SUBJECTS AND METHODS: Mean glandular dose to the breast during
screening mammography was measured for 206 women who had undergone
breast augmentation. For 13 of these women, mean glandular dose from
preoperative mammography also was measured. Effective tube current,
peak kilovoltage, and breast thickness were measured, and mean
glandular dose was calculated for 1,632 images. Two screen-film
combinations and three target-filter combinations were studied.

RESULTS: For four-view augmentation mammography with a
molybdenum-molybdenum (Mo-Mo) target-filter combination, mean
glandular dose was reduced 35%, from 10.7 to 7.0 mGy, by changing the
screen-film combination from 100 to 190 speed. For four-view
augmentation mammography, mean glandular dose was reduced 24% by
changing the target-filter combination from Mo-Mo to rhodium-rhodium
(Rh-Rh) for full views of breasts containing implants. For four-view
augmentation mammography, mean glandular dose was reduced 50% by
changing the screen-film combination from 100 to 190 speed and
changing the target-filter combination from Mo-Mo to Rh-Rh for
implant-full views.

CONCLUSION: Mean glandular dose per breast from four-view augmentation
mammography with the 100-speed screen-film and Mo-Mo target-filter
combinations averaged 10.7 mGy, which is 3.1 times higher than the 3.4
mGy for conventional two-view mammography of breasts without implants.
In 40 years of screening, this number represents a more than tripled
lifetime attributable risk of radiation-induced breast cancer-an
unacceptable level. Use of faster screen-film combinations, use of
Rh-Rh target-filter combinations, and acquisition of three rather than
four views are dose-reduction methods that together result in a 66%
dose reduction, from 10.7 to 3.6 mGy. Mean glandular dose should be
kept less than 7.0 mGy per breast for screening mammography of
patients with breast implants.