Should You Be Worried About the Radiation Dose of A Mammogram?

Let’s be honest, mammograms probably rank right up there with dental appointments on a list of Americans’ favorite pastimes. When I talk to patients about mammograms, I hear a variety of fears about this simple breast cancer screening procedure, with the most frequent being the level of radiation patients are exposed to. Pregnant women, of course, should limit radiation exposure as a precaution, but the idea that we are in danger from mammogram radiation is an alarming myth that has stopped many people from getting the vital preventative healthcare they need.


Myth #1: Mammogram Radiation Exposure Levels Are High

Despite all the concern about mammogram radiation levels, the simple fact is that doses are extremely low. Radiation is measured in millisieverts (mSv). According to the American Cancer Society (1), a typical screening mammogram, the type most patients are recommended to have annually, uses only 0.4 mSv. This includes two views of each breast. Modern 3D mammography can use less radiation or slightly more (0.5-1 mSv) depending on the software or number of images required (2).

Compare that to the 3 mSv background radiation we are all exposed to in our natural everyday surroundings on an annual basis. Getting a mammogram, then, is the equivalent of only 7 weeks of normal everyday life. The federal government has determined radiation workers can safely be exposed to 50 mSv annually (3).

Myth #2: Avoiding Radiation is More Important Than The Benefits of A Screening Mammogram

While we should all avoid radiation exposure if possible, the truth is that the benefits of mammography screening far exceed any downside of the small amount of radiation exposure involved. 43% of U.S. breast cancer cases are found because of mammograms (4), so it’s extremely important to get regular screenings.

Some over-sensationalized stories in the media have claimed that mammograms may lead to overtreatment and are not as useful as we once thought. But studies have shown that mammograms save more lives than they over-diagnose. And a recent Swedish Cancer Institute study found that women ages 40-49 who had mammograms and were later diagnosed with breast cancer, had lower mortality and were easier to treat than women who didn’t have the screening. Mammograms are vital to saving lives and finding breast cancer early, when it’s in its most treatable stages.

Myth #3: There are Effective Low-Radiation Alternatives To Mammograms

Patients who are concerned about radiation levels often ask me about breast imaging alternatives like breast thermography, breast MRIs, and breast ultrasounds. Breast thermography is an unproven technology—the FDA has even issued warning letters to healthcare providers that mislead patients on its effectiveness (5) And while breast MRIs and ultrasounds can be useful tools in a doctor’s arsenal, they should not be used as primary screening methods. No major cancer or medical organization including the Society of Breast Imaging (SBI), the American College of Radiology, the American Cancer Society, or the U.S. Preventive Services Task Force recommend any other primary breast cancer screening method besides a mammogram. I do not recommend or offer any of these as alternatives to my patients, though breast MRI and breast ultrasound may have a role as an adjunct to mammography in certain high risk patients.

Breast self-exams (BSE) and clinical breast exams (CBE) are wonderful detection methods and can be quite effective in finding breast cancer (2), but they are not replacements for a mammogram. If you detect a lump in a breast self-exam or clinical breast exam, you will always need to follow-up with a mammogram and other diagnostic tests to rule out other causes of breast lumps.

Conclusion

Mammograms save lives and are crucial to detecting breast cancer early. Radiation exposure does increase breast cancer risk levels, however the risk levels from a mammogram are miniscule compared to the average woman’s 1 in 8 chance of being diagnosed with breast cancer at some point in her lifetime. There is no reason to be concerned about your radiation exposure from a mammogram. If you are over 40, get your annual mammogram and feel good knowing you are making a positive impact on your health.

Sources

  1. Mammogram Basics, American Cancer Society
  2. How Much Radiation Is In a Mammogram, Wake Radiology
  3. Standards For Protection Against Radiology, United States Nuclear Regulatory Commission
  4. Self-Detection Remains a Key Method of Breast Cancer Detection for U.S. Women, Journal of Women’s Health
  5. FDA Warns Thermography Should Not Be Used in Place of Mammography to Detect, Diagnose, or Screen for Breast Cancer: FDA Safety Communication, U.S. Food & Drug Administration

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