Mammography Diagnostic Reference Level for Breast Cancer Screening Procedures: A Systematic Review
Buhari Samaila · Carcinogenesis and Chemotherapy · 2024
Background: Breast cancer claims about 500,000 lives worldwide each year, although research shows that mortality rates can be cut by up to 30% with early detection. The most crucial diagnostic tool for the early diagnosis of breast cancer is mammography, which is radiographic imaging of the breast using X-rays. Low intensity X-rays are used during mammography to image the breast tissue. Despite the use of low dose radiation, the use of ionizing radiation raises the possibility of causing breast cancer. Aim and Objectives: The main goal of this study was to examine previous and current studies that evaluated mean glandular dose (MGD) and diagnostic reference values during diagnostic mammography procedures around the world. Materials and Method: In order to find studies that assessed glandular doses and established DRLs for mammography (within the years 2003–2022), a systematic search through the literature were conducted using search terms extracted from three terms: Diagnostic Reference Levels (DRLs), Average/mean glandular dose (A/MGD), mammography, and breast screening. Following a screening process, 22 articles out of 700 found throughout the search were included. Relevant information from the included studies was compiled and examined. Result and Discussion: The researchers built seven literatures that established DRL in mammography at the 75th and 95th percentiles. Ten studies produced DRLs at these two percentiles, whereas three studies failed to do so. The compressed breast thickness, exposure factors, average glandular dose, and DRLs all showed differences. Both the techniques and the data are varied. For ten studies, the mean AGD for the CC and MLO projections ranges from 0.31 to 2.46 mGy and 0.46 to 1.82 mGy, respectively. The DRL values range from 0.63 to 3.48 mGy at the 75th percentile and from 2.22 to 3.74 at the 95th percentile for CC projections, respectively.MLO projections were determined to have a 75th and 95th percentile between 1.46 and 2.17 and 2.68 and 3.61 mGy. In terms of both CC/MLO, the range was 2.0 - 13.0 mGy at the 95th percentile and 1.4-6.7 mGy at the 75th percentile. DRL comparisons between nations are made more difficult by these discrepancies; as a result, having a protocol that is widely accepted would be helpful. For the radiation safety of patients, it is crucial to establish DRLs for breast mammography procedures. Conclusion: The mammographic DRL values vary from one country to another. For radiation protection during mammography screening, the creation of DRL is essential. The global mammographic DRLs should be established and maintained.