ORIGINAL PAPER
Ionizing radiation and volumetric mammographic density
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1
Nofer Institute of Occupational Medicine, Łódź, Poland
(Department of Environmental Epidemiology)
2
Nofer Institute of Occupational Medicine, Łódź, Poland
(Department of Radiation Protection)
Online publication date: 2022-08-01
Corresponding author
Joanna Domienik-Andrzejewska
Nofer Institute of Occupational Medicine, Department of Radiation Protection, św. Teresy 8, 91-348 Łódź,
Poland
Int J Occup Med Environ Health. 2022;35(5):635-49
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ABSTRACT
Objectives: Mammographic density (MD) refers to the percentage of dense tissue of an entire breast and was proposed to be used as a surrogate
marker for breast cancer. High-dose ionizing radiation (IR) has been recognized as a breast cancer risk factor. The aim of our study was to investigate
association between lifetime low dose ionizing radiation (LDIR) and MD. Material and Methods: A cross-sectional study included 467 women
aged 40–60 years who underwent screening mammography in Łódź, Poland. The digital mammography examination of the breasts included both
craniocaudal and mediolateral oblique views. The volumetric breast density (VBD) (%) and fibrograndular tissue volume (FG) (cm3) were determined
based on the analysis of mammographic image (“for processing”) using Volpara Imaging Software. The exposure to IR was estimated for each
individual, based on the data from interviews about diagnostic or therapeutic medical procedures performed in the area of the neck, chest, abdomen
and spine, which involved X-rays and γ rays and the data about the doses derived from literature. Linear and logistic regression were fitted with VBD
and FG as the outcomes and organ breast dose, effective dose and number of mammographies as the determinants, adjusted for major confounders. Results: The analyses showed no association between VBD or FG and the breast organ dose or the effective dose. The only significant finding observed
concerned the association between the number of mammographies and the FG volume with β coefficient: 0.028 (95% CI: 0.012–0.043), and
predicted mean FG volume >13.4 cm3 among the women with >3 mammographies when compared to those with none. Conclusions: This study
does not, in general, provide support for the positive association between LDIR and MD. The weak association of the FG volume with the number of
mammographies warrants further verification in larger independent studies. Int J Occup Med Environ Health. 2022;35(5):635–49