Radiation-Induced Breast Cancer Attributable to Mammography Screening: Estimation for France in 2019.

Abstract

Objective: Despite their established clinical benefits, breast cancer screening examinations expose women to ionizing radiation (IR) and call for vigilance regarding protocols and practices. This study estimates the population attributable risk (PAR) of radiation-induced breast cancer in France in 2019 that is attributable to past exposure to IR through screening performed in women aged 40 to 74 years old.

Methods: Breast cancer screening practices were reconstituted for the period 1980 to 2019. Records of recent years were built based on French National Health Data System. An estimation was made for earlier years based on the available literature and expert knowledge. Women diagnosed with a history of breast cancer before mammography were excluded. Absorbed glandular doses to the breast were modeled based on existing literature and reports on French practices. Excess breast cancer cases were estimated using 2 radiation-risk models (Biologic Effects of Ionizing Radiation VII and the International Commission on Radiological Protection).

Results: Of roughly 55 000 new breast cancer cases diagnosed in 2019 in women at least 40 years old, we estimate that approximately 27 might be attributable to past exposures to IR associated with breast cancer screening between the ages of 50 and 74 years. This leads to a PAR of 0.048%. In addition, about 16 cases might be attributable to screening between ages 40 and 49 years, with a PAR of approximately 0.030%.

Conclusion: The contribution of breast cancer screening to the breast cancer burden in France is limited. Efforts to limit the dose delivered to the breast must continue.