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Breast Carcinoma: The Radiologist's Expanded Role

Franklin S. Alcorn, MD
JAMA. 1978;240(7):685. doi:10.1001/jama.1978.03290070087030.
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A major controversy now rages concerning the carcinogenic effects of radiation at doses ordinarily employed in diagnostic mammography. Although a clear-cut answer will not be forthcoming in the immediate future, the radiologist must exert every effort to obtain a good diagnostic image with the lowest possible radiation exposure. This conference presents the current thinking regarding mammographic image production and radiation reduction.

Of the 5 parts, in the book, the first discusses radiation as it relates to cancer induction, benefit-risk ratio in mammography, and a perspective of breast cancer screening controversy. The contributors believe that radiation is indeed carcinogenic, but that estimations of carcinogenesis are at best tenuous. At least in selected patients who are at higher-thannormal risk, breast screening by mammography is desirable.

In part 2 physicists discuss in depth the physical factors affecting mammographic images. These include the effects of scattered radiation on contrast, geometric unsharpness and its related


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