Radioprotection 2024 , 59 ( 2 ), 104 – 110 © SFRP , 2024 https :// doi . org / 10.1051 / radiopro / 2024010 Available online at : www . radioprotection . org ARTICLE
Radiation exposure in routine mammography screening : a large observational cross-sectional study in Morocco
Z . Tahiri 1 ,* , M . Talbi 2 , M . El Mansouri 3 , H . Sekkat 4 , M . Mkimel 4 , O . Nhila 3 , M . Essendoubi 1 and S . Hiroual 1
1 Biophysics Laboratory , Life & Health Sciences Research Laboratory , Faculty of Medicine and Pharmacy of Tangier , Abdelmalek Essaadi University , Tétouan , Morocco . 2 Moulay Ismail University , Faculty of Sciences , Physical Sciences and Engineering , Zitoune Meknès , Morocco . 3 Ibn Tofail University , Faculty of Sciences , Department of Physics , Laboratory of Materials and Subatomic Physics , Kenitra , Morocco . 4 Hassan First University , Higher Institute of Health Sciences , Laboratory of Health Sciences and Technologies , Settat , Morocco .
Received : 27 June 2023 / Accepted : 7 March 2024
Abstract – This observational cross-sectional study aims to assess the exposure levels during mammography examinations in Morocco and provide an international comparative analysis . Patient data from 1100 mammographic examinations conducted in five units , comprising both digital radiography ( DR ) and computed radiography ( CR ) systems from various brands and models in the Rabat-Salé- Zemmour-Zaër region , were collected . The mean glandular dose ( MGD ) and technical parameters , including exposure factors and breast thickness , were analyzed . The collected data were compared with findings from international studies to provide valuable context . The overall median MGD was 1.34 ± 0.36 mGy for craniocaudal ( CC ) and 1.48 ± 0.38 mGy for mediolateral oblique ( MLO ) incidences . It ’ s essential to note that these values were calculated based on the median compressed breast thickness . The MGD varied among different units and anode / filter combinations . The Rh / Rh anode / filter combination was most commonly used , resulting in the lowest radiation dose . The study findings also highlighted the relationship between MGD and breast thickness , with higher doses observed for thicker breasts . This study provides valuable insights into radiation exposure during mammography breast cancer screening in Morocco . The results underscore the importance of future dose optimization strategies to ensure patient safety without compromising diagnostic image quality . Implementing optimized technical parameters , conducting regular quality assurance programs , and promoting education and awareness are essential in achieving dose reduction and minimizing radiation risks . Collaboration among healthcare professionals , regulatory bodies , and international organizations is crucial for sharing best practices and advancing radiation dose optimization in mammography . Keywords : Radiation exposure / mammography / breast cancer screening / patient radiation protection
1 Introduction
The mammography technique offers the possibility of detecting breast cancer at an early stage . The Moroccan national cancer prevention and control plan proposes a screening examination every two years for women aged 40 – 69 , which typically comprises both cranio-caudal ( CC ) and mediolateral oblique ( MLO ) views . For a woman at risk , this can lead her to undergo about 20 mammographic examinations , without counting the other examinations she will experience during her life ( CT scan , standard radiology
* Corresponding author : tahiri . zakaria @ gmail . com examination ). In addition , during a mammogram , a woman may have several image acquisition angles and receive repeated doses . These doses received may be associated with a risk of radiation-induced carcinogenesis ( Talbi et al ., 2022 ; Wanget al ., 2013 ). The linear no-threshold model of risk evaluation of radiological exposures at low doses remain today appropriate for radiological protection purposes ( Laurier et al ., 2023a ; Laurier et al ., 2023b , Bertho and Bourguignon , 2023 ). Thus annual screenings of 100,000 women between the ages of 40 and 74 could result in an average of 125 radiation-induced breast cancers resulting in 16 deaths ( Seimenis et al ., 2018 ).
In the 2007 Recommendations of the International Commission on Radiological Protection ( ICRP ), it was stated that the tissue weighting factor was increased from 0.05 to 0.12