Imaging Research Program, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Ave, Room S6-57, Toronto, ON, Canada M4N 3M5.
Radiology. 2011 Jan;258(1):98-105. doi: 10.1148/radiol.10100655. Epub 2010 Nov 16.
To assess a schema for estimating the risk of radiation-induced breast cancer following exposure of the breast to ionizing radiation as would occur with mammography and to provide data that can be used to estimate the potential number of breast cancers, cancer deaths, and woman-years of life lost attributable to radiation exposure delivered according to a variety of screening scenarios.
An excess absolute risk model was used to predict the number of radiation-induced breast cancers attributable to the radiation dose received for a single typical digital mammography examination. The algorithm was then extended to consider the consequences of various scenarios for routine screening beginning and ending at different ages, with examinations taking place at 1- or 2-year intervals. A life-table correction was applied to consider reductions of the cohort size over time owing to nonradiation-related causes of death. Finally, the numbers of breast cancer deaths and woman-years of life lost that might be attributable to the radiation exposure were calculated. Cancer incidence and cancer deaths were estimated for individual attained ages following the onset of screening, and lifetime risks were also calculated.
For a cohort of 100 000 women each receiving a dose of 3.7 mGy to both breasts and who were screened annually from age 40 to 55 years and biennially thereafter to age 74 years, it is predicted that there will be 86 cancers induced and 11 deaths due to radiation-induced breast cancer.
For the mammographic screening regimens considered that begin at age 40 years, this risk is small compared with the expected mortality reduction achievable through screening. The risk of radiation-induced breast cancer should not be a deterrent from mammographic screening of women over the age of 40 years.
评估一种用于估算因接受乳房电离辐射（如乳房 X 光摄影）而导致乳腺癌风险的方案，并提供可用于估算潜在乳腺癌数量、癌症死亡人数以及因按各种筛查方案进行辐射暴露而导致丧失的女性生命年数的数据。
使用超额绝对风险模型预测归因于单次典型数字乳房 X 光摄影检查所接受的辐射剂量的辐射诱发乳腺癌数量。然后，该算法扩展到考虑不同年龄开始和结束的常规筛查各种方案的后果，检查间隔为 1 年或 2 年。应用寿命表校正以考虑由于非辐射相关原因导致的队列规模随时间减少。最后，计算可能归因于辐射暴露的乳腺癌死亡人数和丧失的女性生命年数。在开始筛查后，针对个体获得的年龄估算乳腺癌发病数和癌症死亡数，并计算终生风险。
对于 100 000 名女性的队列，每位女性接受双侧乳房 3.7 mGy 的剂量，从 40 岁开始每年筛查，此后每两年筛查至 74 岁。预测将有 86 例癌症和 11 例因辐射诱发乳腺癌而导致的死亡。
对于考虑从 40 岁开始的乳房 X 光摄影筛查方案，与通过筛查可实现的预期死亡率降低相比，这种风险很小。辐射诱发乳腺癌的风险不应成为阻止 40 岁以上女性进行乳房 X 光摄影筛查的原因。
