ABSTRACT
Because of the high and increasing incidence of breast cancer in many countries, there is a large and expanding interest in methods of breast dosimetry and the values of the breast dose in the use of mammography as the primary imaging technique for breast screening, as there is a small, but not insignificant, associated risk of radiation induced breast cancer. Besides its use for risk estimation, knowledge of dose is essential for comparison and optimization of system performance, and its measurement is an essential component of quality control procedures for all X-ray based breast imaging systems. This applies to both conventional planar X-ray mammography and to digital breast tomosynthesis (DBT) (Niklason et al. 1997, Sechopolous 2013a,b), which has exciting potential for improved cancer detection because it removes or blurs the effects of overlying tissue that can obscure or simulate the appearance of breast abnormalities in the image (see also Section II, Chapter 19 of this book for a description of digital mammography and Chapter 20 for a description of DBT). This chapter addresses methods of breast dosimetry and their application in national and international protocols. It is limited to conventional 2D mammography (including contrast-enhanced digital mammography, CEDM) and DBT. It does not consider breast CT, partial breast irradiation, or the breast dose arising from X-ray examinations of other parts of the body. The reader is referred to the review by Dance and Sechopoulos (2016) for discussion of the dosimetry for breast CT and partial breast irradiation.
