Radiation and Risk: Head Shoulders Knees and Toes…

As radiologists, we deal with radiation daily. We can image patients with x-rays from their head to their toes; CT scans and nuclear medicine also use radiation; but there is no radiation at all when we image with ultrasound or MRIs. There is a whole separate field of medicine dealing with the use of radiation in the treatment of diseases – radiation oncology.

When it comes to breast health, radiation exposure is important, but for most, not a critical reason for increased breast cancer risk.

Exposure Is Carefully Monitored

There was a time when the risks of radiation exposure were unknown. This means that in the early days radiation was used to treat many benign conditions like acne. It was even used for a time to determine shoe size in stores! The negative effects of large doses of radiation were soon recognized, and management of radiation dose is an integral part of the training of today’s radiologists and radiology technologists.

We work with our team of physicists (yes, radiologists have physicist on their teams!) regularly to assess and address dose. Our team of physicists helped to create a post to address the topic of radiation exposure: What Does Radiation Safety Mean to DIC?

Exposure Doesn’t Always Mean Breast Cancer Risk Increase

Radiation from medical imaging- whether chest films, shoulder films, CT chest, CT neck- is NOT associated with an increased risk of breast cancer. Dose is low for these procedures, and most patients will not have enough of them to add up to be a concern. Modern techniques focus on limiting radiation to the area being examined and using the lowest dose possible to get the images needed to make the diagnosis. These principles govern our use of radiation in imaging.

Chest Radiation Therapy

Radiation therapy to the chest for malignancies is a different story – here larger doses of radiation are being used to destroy a cancer (and save a life). Radiation oncologists make every effort to limit the field of radiation to the area of cancer, sparing adjacent tissues whenever possible.  If the breasts are in the field of radiation, there may be an increase in the risk for breast cancer. This is why patients with Hodgkin’s lymphoma with treatment with radiation to the chest are recommended to screen with breast MRI 10 years after completion of radiation therapy. This will supplement mammographic screening (starting at the usual age) in these patients.

In summary, radiation is powerful stuff, never used lightly. As radiologists, our goal is to use radiation when appropriate and in the lowest possible dose – your overall good health is always our number one priority.

Image credit: Crookes tube xray experiment by Wiliam J. Morton via Wikimedia Commons Copyright Public Domain

Originally published 3/11/14 on mammographykc.com.