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In Vitro Evaluation of Oncogenic Transformation in Human Mammary Epithelial Cells
09:44

In Vitro Evaluation of Oncogenic Transformation in Human Mammary Epithelial Cells

Published on: September 24, 2020

Mammography-oncogenecity at low doses.

G J Heyes1, A J Mill, M W Charles

  • 1Department of Medical Physics, University Hospital Birmingham NHS Foundation Trust, Birmingham B15 2TH, UK.

Journal of Radiological Protection : Official Journal of the Society for Radiological Protection
|May 21, 2009
PubMed
Summary
This summary is machine-generated.

Low energy mammography x-rays may be four times more effective at causing DNA damage than previously thought. While benefits outweigh risks for most, caution is advised for younger women and those with genetic susceptibility.

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Area of Science:

  • Radiobiology and Radiation Oncology
  • Medical Imaging and Diagnostics
  • Public Health and Screening Programs

Background:

  • The biological effectiveness of low energy x-rays used in mammography screening is debated.
  • Current radiation risk estimates often rely on data from high-energy sources like atomic bomb survivors.
  • Mammography x-rays may possess a higher relative biological effectiveness (RBE) than previously assumed.

Purpose of the Study:

  • To compare the biological effectiveness of mammography x-rays with higher energy x-rays.
  • To re-evaluate the risk-benefit analysis of mammography screening in light of new radiobiology data.
  • To assess the implications for specific patient subgroups, including younger women and those with genetic predispositions.

Main Methods:

  • In vitro irradiation of human cell lines using mammography and high-energy x-ray sources.
  • Analysis of pooled data from multiple measurements to determine the RBE for malignant transformation.
  • Comparison of mammography screening risks and benefits, considering updated RBE values.

Main Results:

  • Low energy mammography x-rays demonstrated a significantly higher RBE (up to 4.42 ± 2.02) compared to higher energy x-rays.
  • A pooled analysis indicated a maximal RBE of 4.02 ± 0.72 for 29 kVp x-rays.
  • Despite the increased RBE, the benefits of screening generally outweigh the risks for the majority of women in the UK NHS program.

Conclusions:

  • Mammography x-ray risks may be underestimated by a factor of four, necessitating caution for women under 50 and those with a family history of breast cancer.
  • While the linear no-threshold (LNT) model remains prevalent, alternative screening modalities like MRI show higher sensitivity in genetically susceptible women.
  • The findings support a re-evaluation of screening protocols and suggest considering non-ionizing imaging for high-risk individuals.