Radiation Doses and Risks in Breast Screening

2020 ◽  
Vol 2 (3) ◽  
pp. 188-200 ◽  
Author(s):  
R Edward Hendrick
Keyword(s):  
Cancer Detection ◽  
Breast Imaging ◽  
Radiation Risk ◽  
Digital Breast Tomosynthesis ◽  
Radiation Doses ◽  
Cancer Risks ◽  
Detection Rates ◽  
Molecular Breast Imaging ◽  
Risk Estimates ◽  
Efficient Detection

Abstract This article describes radiation doses and cancer risks of digital breast imaging technologies used for breast cancer detection. These include digital mammography (DM), digital breast tomosynthesis (DBT), and newer technologies such as contrast-enhanced digital or spectral mammography (CEM), whole-breast computed tomography, breast-specific gamma imaging (BSGI), molecular breast imaging (MBI), and positron emission mammography (PEM). This article describes the basis for radiation risk estimates, compares radiation doses and risks, and provides benefit-to-radiation-risk ratios for different breast imaging modalities that use ionizing radiation. Current x-ray–based screening modalities such as DM and DBT have small to negligible risks of causing radiation-induced cancers in women of normal screening age. Possible new screening modalities such as CEM have similar small cancer risks. Potential screening modalities that involve radionuclide injection such as BSGI, MBI, and PEM have significantly higher cancer risks unless efficient detection systems and reduced administered doses are used. Benefit-to-radiation-risk estimates are highly favorable for screening with DM and other modalities having comparable (or higher) cancer detection rates and comparably low radiation doses.

scholarly journals Pros and cons for breast cancer screening with tomosynthesis – a review of the

2020 ◽  
Author(s):  
Julian Hans Kleinknecht ◽  
Anca Ileana Ciurea ◽  
Cristiana Augusta Ciortea
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Breast Imaging ◽  
Digital Breast Tomosynthesis ◽  
Detection Rates ◽  
Breast Tomosynthesis ◽  
Screening Programs ◽  
Long Term Follow Up ◽  
Imaging Research

Breast cancer screening programs using mammography proved their value in detecting breast cancer at early stages and, consequently, reducing the mortality from this disease. Due to the technological progress, the screening programs have shifted from screen-film mammography to digital mammography and nowadays digital breast tomosynthesis became the focus of breast imaging research. Using tomosynthesis in screening increases cancer detection rates and decreases recall and false-positive rates, thus improving the effectiveness of breast cancer screening programs, with positive consequences on health care costs and on patient psychology. More long-term follow-up data must be collected for assessing absolute sensitivity and specificity of digital breast tomosynthesis, together with efforts for addressing the limitations of the method.

scholarly journals Contribution of clinical breast exam to cancer detection in women participating in a modern screening program

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tehillah S. Menes ◽  
Dan Coster ◽  
Daniel Coster ◽  
Shani Shenhar-Tsarfaty
Keyword(s):  
Cancer Detection ◽  
Breast Imaging ◽  
Screening Program ◽  
Insurance Coverage ◽  
Screening Mammography ◽  
Routine Screening ◽  
Breast Cancers ◽  
Detection Rates ◽  
Clinical Breast Exam ◽  
Clinical Breast

Abstract Purpose Despite the controversy surrounding the role of clinical breast exam (CBE) in modern breast cancer screening, it is widely practiced. We examined the contribution of CBE in women undergoing routine screening mammography and in women under the screening age. Methods A retrospective cohort study including all women participating in a voluntary health screening program between 2007 and 2016. All participants undergo CBE; Screening mammography is done selectively based on age, breast imaging history and insurance coverage. Data collected included demographics, risk factors, previous imaging, and findings on CBE and mammography. Cancer detection rates within 3 months of the visit were calculated separately for women undergoing routine screening mammography, and women under the screening age. Results There were 14,857 CBE completed in 8378; women; 7% were abnormal. Within 3 months of the visit, 35 breast cancers (2.4 per 1000 visits) were diagnosed. In women within the screening age who completed a mammogram less than one year prior to the visit (N = 1898), 4 cancers (2.1 cancers per 1000 visits) were diagnosed. Only one was diagnosed in a woman with an abnormal CBE, suggesting that the cancer detection rate of CBE in women undergoing regular screening is very low (0.5 per 1000 visits). In women under the screening age (45), 3 cancers (0.4 per 1000 visits) were diagnosed; all were visualized on mammography, one had an abnormal CBE. Conclusions The contribution of CBE to cancer detection in women undergoing routine screening and in women under the screening age is rare.

scholarly journals Tomosynthesis-Guided Core Biopsy of the Breast: Why and How to Use it

2018 ◽  
Vol 8 ◽  
pp. 28 ◽  
Author(s):  
Kyungmin Shin ◽  
Davis Teichgraeber ◽  
Sarah Martaindale ◽  
Gary J Whitman
Keyword(s):  
Cancer Detection ◽  
Core Biopsy ◽  
Breast Imaging ◽  
Detection Rate ◽  
Clinical Symptoms ◽  
Digital Breast Tomosynthesis ◽  
Screening Mammography ◽  
Cancer Detection Rate ◽  
Breast Tomosynthesis

Digital breast tomosynthesis (DBT) has become an important tool in breast imaging. It decreases the call-back rate while increasing the cancer detection rate on screening mammography and is useful for diagnostic examination of noncalcified lesions and for the evaluation of patients presenting with clinical symptoms. Management challenges and dilemmas that are encountered with abnormalities detected on DBT and lacking a sonographic correlate can now be addressed with tomosynthesis-guided core biopsy.

Digital Breast Tomosynthesis: What Have We Learned?

2019 ◽  
Vol 1 (1) ◽  
pp. 9-22 ◽  
Author(s):  
Reni Butler ◽  
Emily F Conant ◽  
Liane Philpotts
Keyword(s):  
Breast Imaging ◽  
Breast Biopsy ◽  
Digital Breast Tomosynthesis ◽  
Molecular Characteristics ◽  
Architectural Distortion ◽  
Luminal A ◽  
Detection Rates ◽  
Breast Tomosynthesis ◽  
Multiple Data Sets ◽  
Invasive Carcinomas

Abstract Digital breast tomosynthesis (DBT) is increasingly recognized as a superior breast imaging technology compared with 2D digital mammography (DM) alone. Accumulating data confirm increased sensitivity and specificity in the screening setting, resulting in higher cancer detection rates and lower abnormal interpretation (recall) rates. In the diagnostic environment, DBT simplifies the diagnostic work-up and improves diagnostic accuracy. Initial concern about increased radiation exposure resulting from the DBT acquisition added onto a 2D mammogram has been largely alleviated by the development of synthesized 2D mammography (SM). Continued research is underway to reduce artifacts associated with SM, and improve its comparability to DM. Breast cancers detected with DBT are most often small invasive carcinomas with a preponderance for grade 1 histology and luminal A molecular characteristics. Recent data suggest that higher-grade cancers are also more often node negative when detected with DBT. A meta-analysis of early single-institution studies of the effect of DBT on interval cancers has shown a modest decrease when multiple data sets are combined. Because of the greater conspicuity of lesions on DBT imaging, detection of subtle architectural distortion is increased. Such findings include both spiculated invasive carcinomas and benign etiologies such as radial scars. The diagnostic evaluation of architectural distortion seen only with DBT can pose a challenge. When no sonographic correlate can be identified, DBT-guided biopsy and/or localization capability is essential. Initial experience with DBT-guided procedures suggests that DBT biopsy equipment may improve the efficiency of percutaneous breast biopsy with less radiation.

scholarly journals Molecular breast imaging and background uptake of fibroglandular tissue as tools to predict neoplasms in dense breasts

Mastology ◽  
2021 ◽  
Vol 31 ◽  
Author(s):  
Carla Lima Santos Viviani ◽  
Lucimara Priscila Veras ◽  
Dionísio Nepomuceno Viviani ◽  
Amanda Sofia Silva Mascarenhas ◽  
Rivadávio Fernandes Batista de Amorim
Keyword(s):  
Cancer Detection ◽  
Breast Imaging ◽  
Low Cost ◽  
Screening Method ◽  
High Patient Satisfaction ◽  
Molecular Breast Imaging ◽  
Gamma Imaging ◽  
Complementary Method ◽  
Dense Breasts ◽  
Fibroglandular Tissue

The sensitivity of mammography as a screening method is low in dense breasts, which are associated with a high risk of developing tumors. Thus, molecular breast imaging (MBI) with background uptake (BPU) of fibroglandular tissue can be used as a complementary method. The aim of this review was to synthesize the existing evidence on these important diagnostic imaging tools. Three electronic databases were searched to identify original articles, including publications dating from September 2010 and September 2020, in English, conducted in any location, and addressing at least one aspect related to dense breasts and Breast-specific gamma-imaging (BSGI). In total, 22 studies were reviewed. Several advantages of MBI and BPU as complementary methods of screening for dense breasts were found. Among them, we can mention the increase in breast cancer detection rate, easy implementation in clinical practice, high patient satisfaction, low cost and good reproducibility. In view of the good results found in our review, we can conclude that the implementation of MBI, especially with BPU, can be a promising complementary tool for screening of dense breasts.

scholarly journals 1275Lifetime cancer risks from occupational radiation exposure among workers at interventional radiology departments

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Won Jin Lee ◽  
Ye Jin Bang ◽  
Young Min Kim ◽  
Sung Bum Cho
Keyword(s):  
Interventional Radiology ◽  
Radiation Exposure ◽  
Radiation Risk ◽  
Radiological Protection ◽  
Radiation Doses ◽  
Cancer Risks ◽  
Potential Health ◽  
Occupational Radiation Exposure ◽  
Radiologic Technologists ◽  
Occupational Radiation

Abstract Background Interventional medical radiation workers represent an under-studied population worldwide, although they receive relatively high occupational radiation doses. This study aimed to estimate the lifetime cancer risk from occupational radiation exposure among workers at interventional radiology departments. Methods A field survey of interventional medical workers in nationwide branches of the Korean Society of Interventional Radiology was conducted in 2017. Organ-specific radiation doses were estimated using national dose registry data and conversion coefficients provided by the International Commission on Radiological Protection. Lifetime attributable risk (LAR) and lifetime fractional risk (LFR) were calculated based on realistic exposure scenarios using a radiation risk assessment tool. Results LARs from occupational radiation exposure until the age of retirement for all cancers combined were 338 (90.3-796.1), 121 (33.5-288.7), and 156 (41.1-390.6) per 100,000 individuals for male radiologists, male radiologic technologists, and female nurses, respectively. LFR for all cancers combined ranged from 0.22% (0.06-0.53) to 0.63% (0.17-1.47). Regarding the organ site, the highest LAR and LFR among all groups were observed for thyroid cancer. Conclusions This study provides timely evidence of potential cancer burden from the current levels of occupational radiation exposure among workers at interventional radiology departments. The risks varied by occupational groups, and workers, particularly interventional radiologists, need to be carefully monitored for radiation. Key messages We projected lifetime cancer risks from occupational radiation exposure among workers at interventional radiology departments in South Korea. Particularly, interventional radiologists, should be prioritized for careful protection from the potential health risks of occupational radiation exposure.

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