The effect of breast composition on absorbed dose and image contrast

We have studied the effect of breast composition on the average whole breast dose, average glandular dose, and image contrast in mammography, using both computational and experimental methods. Three glandular/adipose compositions were considered: 30/70, 50/50, and 70/30 by weight, for both 3- and 5-cm breast thickness. Absorbed dose was found to increase with greater glandular content and this increase is more pronounced for thick breasts and softer beams. For typical screen-film x-ray beams, the average dose to a highly glandular breast is nearly twice the dose to a highly adipose breast and the average glandular dose about 40% higher. Dose was reduced when higher energy beams were employed. The use of a grid increased the dose by a factor of 2.0 to 2.6. Finally, the measured image contrast decreases with increasing breast glandularity, to a greater extent in small breasts and when low energy beams were employed.