Radiation risk with digital mammography in breast screening

This review estimates the risks and benefits of breast screening in terms of deaths due to radiation-induced cancers and lives saved by digital mammography in the NHS Breast Screening Programme in England.

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A radiation risk model, patient dose data and data from national screening statistics were used to estimate the number of deaths due to radiation induced breast cancers in the NHSBSP in England. The breast cancer mortality reduction in the invited population due to screening, and the percentage of women diagnosed with symptomatic breast cancer who die from that cancer, were collated from the literature. The number of lives saved due to screening was calculated.

The main findings are that:

  • the risk of a radiation-induced cancer for a woman attending full field digital mammographic screening (2 views) by the NHSBSP is between 1 in 49,000 to 1 in 98,000 per visit
  • if a woman attends all 7 screening examinations between the ages of 50 to 70, the risk of a radiation-induced cancer is between 1 in 7,000 to 1 in 14,000
  • it is estimated that about 400 to 800 cancers are detected by the NHSBSP for every cancer induced
  • the mortality benefit of screening exceeds the radiation-induced detriment by about 150:1 to 300:1
  • for the small proportion of women with breasts thicker than 90mm who receive higher radiation doses, the benefit will exceed the risk by about 100:1 to 200:1

Full report at Public Health England

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