Breast Cancer Risk from Different Mammography Screening Practices

Mammography screening is an accepted procedure for early detection of breast tumors among asymptomatic women. Since this procedure involves the use of X rays, it is itself potentially carcinogenic. Although there is general consensus about the benefit of screening for older women, screening practice...

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Bibliographic Details
Published in:Radiation research 2010-09, Vol.174 (3), p.367-376
Main Authors: Bijwaard, Harmen, Brenner, Alina, Dekkers, Fieke, van Dillen, Teun, Land, Charles E., Boice, John D.
Format: Article
Language:English
Subjects:
Adult
Aged
Breast cancer
Breast neoplasms
Breast Neoplasms - diagnostic imaging
Breasts
Cancer
Cancer screening
Carcinogenesis
Female
Humans
Mammography
Mammography - adverse effects
Middle Aged
Neoplasms, Radiation-Induced
Puberty
Radiation genetics
Research s
Risk
Tumors
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Summary:Mammography screening is an accepted procedure for early detection of breast tumors among asymptomatic women. Since this procedure involves the use of X rays, it is itself potentially carcinogenic. Although there is general consensus about the benefit of screening for older women, screening practices differ between countries. In this paper radiation risks for these different practices are estimated using a new approach. We model breast cancer induction by ionizing radiation in a cohort of patients exposed to frequent X-ray examinations. The biologically based, mechanistic model provides a better foundation for the extrapolation of risks to different mammography screening practices than empirical models do. The model predicts that the excess relative risk (ERR) doubles when screening starts at age 40 instead of 50 and that a continuation of screening at ages 75 and higher carries little extra risk. The number of induced fatal breast cancers is estimated to be considerably lower than derived from epidemiological studies and from internationally accepted radiation protection risks. The present findings, if used in a risk-benefit analysis for mammography screening, would be more favorable to screening than estimates currently recommended for radiation protection. This has implications for the screening ages that are currently being reconsidered in several countries.
ISSN:0033-7587
1938-5404
DOI:10.1667/RR2067.1