International Agency for Research on Cancer, Lyon, France.
Radiat Res. 2012 Jan;177(1):92-108. doi: 10.1667/rr2241.1. Epub 2011 Oct 12.
The assessment of potential benefits versus harms from mammographic examinations as described in the controversial breast cancer screening recommendations of the U.S. Preventive Task Force included limited consideration of absorbed dose to the fibroglandular tissue of the breast (glandular tissue dose), the tissue at risk for breast cancer. Epidemiological studies on cancer risks associated with diagnostic radiological examinations often lack accurate information on glandular tissue dose, and there is a clear need for better estimates of these doses. Our objective was to develop a quantitative summary of glandular tissue doses from mammography by considering sources of variation over time in key parameters, including imaging protocols, X-ray target materials, voltage, filtration, incident air kerma, compressed breast thickness, and breast composition. We estimated the minimum, maximum and mean values for glandular tissue dose for populations of exposed women within 5-year periods from 1960 to the present, with the minimum to maximum range likely including 90% to 95% of the entirety of the dose range from mammography in North America and Europe. Glandular tissue dose from a single view in mammography is presently about 2 mGy, about one-sixth the dose in the 1960s. The ratio of our estimates of maximum to minimum glandular tissue doses for average-size breasts was about 100 in the 1960s compared to a ratio of about 5 in recent years. Findings from our analysis provide quantitative information on glandular tissue doses from mammographic examinations that can be used in epidemiological studies of breast cancer.
美国预防工作组有争议的乳腺癌筛查建议中描述的乳腺 X 光检查潜在益处与危害的评估包括对乳腺纤维腺体组织(腺体组织剂量)的吸收剂量的有限考虑,即乳腺癌风险组织。与诊断放射学检查相关的癌症风险的流行病学研究通常缺乏关于腺体组织剂量的准确信息,因此非常需要更好地估计这些剂量。我们的目标是通过考虑关键参数随时间的变化来源,包括成像协议、X 射线靶材料、电压、过滤、入射空气比释动能、压缩乳房厚度和乳房组成,来对乳腺 X 光检查中的腺体组织剂量进行定量总结。我们估计了从 1960 年到现在的 5 年内暴露于 X 射线的女性群体中腺体组织剂量的最小、最大和平均值,最小到最大范围可能包括北美和欧洲乳腺 X 光检查中腺体组织剂量的 90%到 95%。乳腺 X 光检查中单次检查的腺体组织剂量目前约为 2 毫戈瑞,约为 20 世纪 60 年代的六分之一。我们对平均大小乳房的最大和最小腺体组织剂量的估计比值在 20 世纪 60 年代约为 100,而近年来的比值约为 5。我们分析的结果提供了乳腺 X 光检查中腺体组织剂量的定量信息,可用于乳腺癌的流行病学研究。