Radiation doses for patients undergoing digital mammography in Saint Petersburg and Leningrad Region

   The gold standard for early diagnosis of malignant breast neoplasms is mammography (X-ray examination of the breast) performed using digital and analogue X-ray units. This procedure is routinely conducted for all women aged 40 to 75 years on a regular basis (once every one or two years); mammography of both breasts is performed in two projections (four X-ray images). Doses from mammography, in accordance with the Norms of the Radiation Safety NRB 99/2009, shall not exceed 1 mSv per year. Hence, reliable assessment of patient doses for this procedure is important.

   The aim of this study was to evaluate the patient doses from mammographic procedures in medical facilities in St. Petersburg and the Leningrad Region.

   Materials and Methods: Data collection was performed at 99 medical facilities in St. Petersburg and the Leningrad Region for 141 digital mammography units during the period 2023–2025. For each mammography unit, mean glandular dose and effective dose was assessed for various compressed breast thicknesses (2, 4, 6, 8, and 10 cm) and projections (craniocaudal and mediolateral oblique), in accordance with the methodological guidelines MU 2.6.1.2944-11.

   Results and Discussion: The mean effective doses per single mammographic image in either the craniocaudal or mediolateral oblique projection varied from 0.05 to 0.07 mSv; effective doses per complete mammographic examination (two craniocaudal and two mediolateral oblique images) varied from 0.2 to 0.3 mSv. At the same time, substantial differences in patient dose ranges were observed: the ratio between the minimum and maximum mean glandular dose and effective dose reached up by the factor of 60, respectively. The primary factors determining patient exposure doses were the exposure and the X-ray tube output. No significant correlation was found between patient doses and tube voltage, focal-image distance, or the anode/filter combination. Compressed breast thickness also did not significantly influence the effective dose.

   Conclusion: Although the mean patient exposure levels during digital mammography are acceptable and comparable with international practice, patient doses for several mammography units are anomalously high. For such units, the implementation of patient radiation protection optimization measures is a priority.

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