title: Mismatch in breast and detector size during screening and diagnostic mammography results in increased patient radiation dose.
abstract: OBJECTIVE
  When using mammographic detectors of different sizes, it can be difficult to match patient breast size to optimal detector size. We studied whether a mismatch between breast size and optimal detector size resulted in increased radiation exposure.
  
  
  METHODS
  All screening and diagnostic (Dx) mammography patients during a 6-week period in November-December 2009 (864 patients) were evaluated (institutional review board exemption for quality assurance studies). Data gathered included breast size (large or small), detector size used, number of views obtained, mean glandular dose (MGD) per breast, and patient waiting time. Average MGD and average waiting time was calculated for imaging performed on appropriately matched or mismatched breast size-detector size pairs.
  
  
  RESULTS
  Screening mammography patients with large breasts imaged on a small detector received a significantly higher radiation dose (4.9 vs. 3.3 mGy, P < .05) and a greater number of views (5.9 vs. 4.6, P < .05) compared to optimally matched breast-detector pairs. Dx mammography patients with large breasts imaged on a small detector received a higher radiation dose (8.2 vs. 6.7 mGy, P < .05) compared to optimally matched breast-detector pairs, although without an increased number of views. Waiting times were longer for a large detector.
  
  
  CONCLUSIONS
  A mismatch in breast-detector sizes results in a significantly greater radiation dose to patients with large breasts imaged on a small detector. Pressure to minimize patient waiting time may inadvertently result in increased radiation dose. Detector size should be matched to breast size whenever possible, but particularly for patients with larger breast sizes.
authors: Department of Radiology, Albany Medical Center South Clinical Campus, 25 Hackett Blvd, Albany, NY 12208; Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215. Electronic address: wellsc@mail.amc.edu.
authors: Catherine L
authors: CL
authors: Wells
authors: Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215.
authors: Priscilla J
authors: PJ
authors: Slanetz
authors: Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215; Department of Radiology, University of Massachusetts Memorial Medical Center and University of Massachusetts School of Medicine, Worcester, MA.
authors: Max P
authors: MP
authors: Rosen
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008327:Mammography / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement / Q000295:instrumentation* / Q000379:methods; D011874:Radiometry / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014850:Waiting Lists
keywords: Radiation dose; detector size; mammography