Biostatistics Seminar Series
Tuesday, November 3rd, 4:10pm, 1043 Gladys Valley Hall
Speaker: Diana Miglioretti, (Dept. Public Health Sciences, UC Davis)
Title: Radiation-Induced Breast Cancer Incidence and Mortality from Digital Mammography Screening: A Modeling Study
Abstract: Controversy around breast cancer screening continues. While most countries and organizations agree that biennial mammography screening from ages 50-74 reduces breast cancer mortality and that the benefits outweigh the harms in this age group, debate continues about whether to start screening earlier, stop screening later, and or to screen more or less frequently. When organizations such as the US Preventative Services Task Force develop screening guidelines, they evaluate whether the benefits of a potential screening strategy outweigh the harms. A potential harm of screening with mammography is radiation exposure, which can increase cancer risk. Previous estimates of radiation-induced breast cancer risk from mammography screening have not considered dose exposure variation or diagnostic work-up after abnormal screening. To estimate distributions of radiation-induced breast cancer incidence and mortality from digital mammography screening, considering exposure from screening and diagnostic mammography and dose variation across women, we used two simulation-modeling approaches using common data on screening mammography from the Breast Cancer Surveillance Consortium and radiation dose from mammography from the Digital Mammographic Imaging Screening Trial. We found that radiation-induced breast cancer incidence and mortality from digital mammography screening are impacted by dose variability from screening and resultant diagnostic work-up, initiation age, and screening frequency. Women with large breasts may be at higher risk of radiation-induced breast cancer; however, the benefits of screening outweigh these risks.