Radiation dose in mammography: an energy-balance approach

An energy-balance approach for calculation of mean, integral, and midpoint doses in mammography is introduced. Estimation of mean absorbed dose for individual applications is described. Differences in breast composition and thickness are accounted for by simple measurements of entrance and exit exposures. Calculations made for a range of xeromammographic techniques used at various breast cancer detection centers show that although increasing the beam h.v.l. dramatically decreases breast surface exposure, it is insignificant in lowering mean breast dose or radiation risk. Thus selection of a moderate h.v.l. to optimize image quality (soft-tissue contrast) in xeromammography may be more beneficial than unduly increasing h.v.l. merely to reduce surface exposure. The mean breast dose per mammogram with low-h.v.l. screen-film techniques was 3 to 9 times lower than for xeromammography, suggesting that general acceptance of screen-film techniques can significantly reduce the risk associated with mammography.