Evaluation of mean glandular dose in relation to breast density in digital mammography

Abstract Background Mammography is considered an ideal tool for breast cancer screening due to its proven effectiveness, which has led to its widespread use as the primary imaging modality for early detection. In addition, mammography is associated with a radiation dose represented as the mean glandular dose (MGD), resulting in a risk of developing breast cancer. However, efforts are being made to reduce this radiation dose. The objective of this study was to identify the MGD during screening mammography based on breast densities and investigate the correlation between MGD and BMI, breast thickness, and compression force in digital mammography. A total of 176 participants, exposed to two basic projections cranio-caudal (CC) projection and medio-lateral oblique (MLO) projection. Breast density was classified according to the guidelines by the American College of Radiology as Breast Imaging Reporting and Data System. Results Mean glandular dose (MGD) increased progressively with breast density, ranging from 8.80 ± 2.74 mGy in Category A (fatty) to 11.27 ± 3.43 mGy in Category D (extremely dense). MLO projections consistently showed higher MGD than CC views. A strong positive correlation was observed between breast thickness and MGD ( r = 0.80 in left MLO). MGD also showed a moderate positive correlation with BMI ( r = 0.44), while compression force had minimal impact. Conclusion Breast density, breast thickness, and BMI significantly influence the mean glandular dose in digital mammography. High breast density and thickness, along with increased BMI, are associated with elevated radiation doses, highlighting the need for personalized dose optimization to ensure effective and safe breast cancer screening.