Is there an association between ionizing radiation exposure from X-rays (x-radiation) and increased incidence of breast cancer in radiologic technologists?

From the Guidelines

There is evidence suggesting a potential association between ionizing radiation exposure from X-rays and an increased incidence of breast cancer in radiologic technologists, particularly those exposed at younger ages. The association between ionizing radiation exposure and breast cancer risk is supported by studies indicating that radiation exposure imposes health risks to both patients and operators, resulting in an increased likelihood of numerous illnesses and diseases 1. While the evidence is not entirely conclusive, recent reports have suggested a signal for increased breast cancer risk in individuals occupationally exposed to radiation 1. Key factors influencing this risk include the dose-dependent nature of radiation exposure, with higher cumulative exposure correlating with greater cancer risk, and the age at which exposure occurs, with younger ages being more radiosensitive 1. The biological mechanism underlying this association involves radiation causing DNA damage and genomic instability in breast tissue cells, potentially leading to malignant transformation. To minimize the risk of breast cancer and other radiation-related health issues, it is essential for radiologic technologists and other healthcare workers to adhere to modern radiation protection measures, including the use of lead aprons, thyroid shields, proper distance from radiation sources, and radiation badges for monitoring exposure 1. Additionally, following the ALARA principle (As Low As Reasonably Achievable) and undergoing regular monitoring can help minimize lifetime radiation exposure and associated cancer risk. Some of the key evidence supporting these recommendations includes:

• A study published in the Journal of the American College of Cardiology in 2020, which highlighted the risks of radiation exposure, including the potential for increased breast cancer risk 1.
• A 2018 expert consensus document on the optimal use of ionizing radiation in cardiovascular imaging, which emphasized the importance of minimizing radiation exposure and provided guidance on best practices for safety and effectiveness 1. Overall, while the evidence is not yet definitive, it suggests that radiologic technologists and other healthcare workers should take precautions to minimize their exposure to ionizing radiation and reduce their risk of breast cancer and other radiation-related health issues.

From the Research

Association Between Ionizing Radiation Exposure and Breast Cancer

• There is evidence to suggest an association between ionizing radiation exposure from X-rays and increased incidence of breast cancer in radiologic technologists 2, 3, 4, 5.
• Studies have shown that occupational exposure to ionizing radiation, including X-rays, may increase the risk of breast cancer, particularly in women who began working with radiation at a young age 3, 4, 5.
• The risk of radiation-induced breast cancer is higher in women who have undergone radiotherapy for either malignant or non-malignant diseases, including benign breast diseases, in their childhood or young age 4, 5.
• The association between ionizing radiation and breast cancer risk is complex and may be influenced by various factors, including dose, age at exposure, and individual susceptibility 3, 4, 5.

Key Findings

• A study of US radiologic technologists found that higher doses of occupational radiation were associated with increased breast cancer incidence, with an excess relative risk at 100 mGy of 0.07 (95% CI: -0.005 to 0.19) 3.
• Another study found that the risk of radiation-induced breast cancer was highest in women who had undergone radiotherapy for lymphomas, and that patients with BRCA1 or BRCA2 mutations may be more sensitive to the deleterious effects of ionizing radiation 5.
• A review of the literature found that the radiation-induced breast cancer risk increases with longer follow-up, higher radiation dose, and younger age of exposure 5.

Radiation Exposure and Breast Cancer Risk

• Ionizing radiation exposure from X-rays has been identified as a potential risk factor for breast cancer, particularly in women who work with radiation or have undergone radiotherapy 2, 3, 4, 5.
• The risk of breast cancer associated with ionizing radiation exposure is generally considered to be low, but it may be higher in certain subgroups, such as women with BRCA1 or BRCA2 mutations 5.
• Further research is needed to fully understand the association between ionizing radiation exposure and breast cancer risk, and to develop effective strategies for reducing this risk in radiologic technologists and other individuals who work with radiation 2, 3, 4, 5.