The Effect of Breast Size and Density in Turkish Women on Radiation Dose in Full-Field Digital Mammography

Abstract

Objective: The purpose of this study was to look into the relationship between breast size and mammographic breast density in women and breast radiation dose on full-field digital mammography (FFDM), as well as the factors that influence radiation dose. Materials and Methods: The study included a total of 2,060 FFDM images from 515 consecutive participants. The participants were divided into two groups: those exposed to high doses (>3 mGy) and those exposed to low doses (<3 mGy). Moreover, the researchers analyzed the relationship between mean glandular dose (MGD) of the breast and patient age, compressed breast thickness, compression force, mammographic breast composition, and mammographic breast size. Results: The mean mammographic breast volume was 936.2 ± 425.2 (114.5–3,018) mL, and the mean compressed breast tissue thickness was 56.75 ± 10.44 mm. Moreover, the mean MGD in the high-dose group was 3.51 ± 0.48 mGy and 1.92 ± 0.56 mGy in the low-dose group. The high-dose group had greater breast thickness, diameters, volume, compression pressure, and surgical rate. However, the high-dose group was younger and had less dense breasts. In multivariate logistic regression analysis, the most important predictors of dose determination were breast thickness [odds ratio (OR): 1.178, 95% confidence interval (CI): 1.156–1.200, p<0.001], history of previous surgery (OR: 2.210, 95% CI: 1.417–3.447, p<0.001), compression force (OR: 1.008, 95% CI: 1.004–1.013, p<0.001), and breast density (OR: 1.873, 95% CI: 1.359–2.580, p<0.001). Conclusion: Women with larger breast volumes are subjected to higher doses of radiation. Therefore, breast-screening programs can be individualized to young women with larger breast volumes and women who have had breast-conserving surgery.