Breast Cancer Induced by X-Ray Mammography Screening? A Review Based on Recent Understanding of Low-Dose Radiobiology

Area of Science:

• Radiology
• Oncology
• Radiobiology

Background:

• Screening mammography detects early-stage cancers, reducing mortality.
• Low-dose X-ray mammography involves ionizing radiation, posing a potential carcinogenesis risk.

Purpose of the Study:

• To review radiobiological data and simulate radiation-induced breast cancer risk from screening mammography.
• To compare this risk against baseline incidence in a population.

Main Methods:

• Review of novel radiobiological data.
• Simulation of radiation-induced breast cancer incidence using modern digital mammography (2.5 mGy glandular dose).
• Calculation of incidence rate ratios for biennial screening in women aged 50-74, assuming no latency time.

Main Results:

• Biennial screening estimated to yield an induced incidence rate over baseline of approximately 1.6‰.
• This could be as low as 0.7‰ based on updated radiobiological data.
• Carcinogenic risk is considered small relative to screening benefits, especially without accounting for latency.

Conclusions:

• Radiation-induced breast cancer risk from screening mammography is generally small but present.
• Individuals with genetic predispositions or hypersusceptibility should minimize ionizing radiation exposure.
• Alternatives such as ultrasound or MRI are recommended for high-risk individuals.