Radiation dose affected by mammographic composition and breast size: first application of a radiation dose management system for full-field digital mammography in Korean women.
BACKGROUND
Relative to Western women, Korean women show several differences in breast-related characteristics, including higher rates of dense breasts and small breasts. We investigated how mammographic composition and breast size affect the glandular dose during full-field digital mammography (FFDM) in Korean women using a radiation dose management system.


METHODS
From June 1 to June 30, 2015, 2120 FFDM images from 560 patients were acquired and mammographic breast composition and breast size were assessed. We analyzed the correlations of patient age, peak kilovoltage (kVp), current (mAs), compressed breast thickness, compression force, mammographic breast composition, and mammographic breast size with the mean glandular dose (MGD) of the breast using a radiation dose management system. The causes of increased radiation were investigated, among patients with radiation doses above the diagnostic reference level (4th quartile, ≥75%).


RESULTS
The MGD per view of 2120 images was 1.81 ± 0.70 mGy. In multivariate linear regression analysis, age was negatively associated with MGD (p < 0.05). The mAs, kVp, compressed breast thickness, and mammographic breast size were positively associated with MGD (p < 0.05). The "dense" group had a significantly higher MGD than the "non-dense" group (p < 0.05). Patients with radiation dose values above the diagnostic reference value had large breasts of dense composition.


CONCLUSIONS
Among Korean women, patients with large and dense breasts should be more carefully managed to ensure that a constant radiation dose is maintained.
Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
Ji Eun
JE
Baek
Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea. lionmain@catholic.ac.kr.
Bong Joo
BJ
Kang
Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
Sung Hun
SH
Kim
Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
Hyun Sil
HS
Lee
D000328:Adult; D001940:Breast / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006984:Hypertrophy / Q000000981:diagnostic imaging* / Q000473:pathology; D008327:Mammography / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement; D056910:Republic of Korea; D014057:Tomography, X-Ray Computed / Q000379:methods*
Digital mammography; FFDM; Radiation dose