Breast Cancer Research and Treatment

, Volume 109, Issue 1, pp 77–90 | Cite as

Low-dose medical radiation exposure and breast cancer risk in women under age 50 years overall and by estrogen and progesterone receptor status: results from a case–control and a case–case comparison

  • Huiyan Ma
  • Colin K. Hill
  • Leslie Bernstein
  • Giske UrsinEmail author


Although moderate to high-dose ionizing radiation exposure is an established risk factor for breast cancer, the effect of low-dose radiation exposure has not been clarified by epidemiological data. We evaluated the effect of low-dose radiation from medical procedures on risk of breast cancer overall and by joint estrogen and progesterone receptor (ER/PR) status in 1,742 population-based case patients aged 20–49 years and 441 control subjects identified from neighbourhoods of case patients in Los Angeles County. After excluding radiation exposures in the 5 years prior to case’s diagnosis or control’s initial household contact date we found an elevated breast cancer risk among women who reported having had multiple chest X-rays (P trend  = 0.0007) or 7 or more mammograms (odds ratio [OR] = 1.80, 95% confidence interval [CI] = 0.95–3.42). Risk was also increased among women who received dental X-rays without lead apron protection before age 20 years (OR = 1.81, 95% CI = 1.13–2.90). Women, who had their first exposure to these medical radiation procedures during childhood, had a greater increase in risk than those who were first exposed at older ages. Although not statistically significantly different, risk estimates were somewhat stronger for nulliparous than for parous women. We found no effect modification by ER/PR status. In conclusion, our findings support the hypothesis that low-dose ionizing radiation, and particularly exposures during childhood, increase breast cancer risk.


Breast cancer Medical radiation Estrogen receptor Progesterone receptor Case–control study 



The authors are deeply grateful to the study interviewers and to Ms. Juliana Bamrick for managing the data collection activities. This study was supported by grants CA17054 and CA74847 from the National Cancer Institute, National Institutes of Health, 4PB-0092 from the California Breast Cancer Research Program of the University of California, and grant P30 ES 07048 from the National Institute of Environmental Health Sciences. The collection of cancer incidence data used in this publication was supported by the California Department of Health Services as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract N01-PC-35139 and the Centers for Disease Control and Prevention’s National Program of Cancer Registries, under agreement #U55/CCR921930-02. The ideas and opinions expressed herein are those of the authors, and no endorsement by the State of California, Department of Health Services, the National Cancer Institute, and the Centers for Disease Control and Prevention or their contractors and subcontractors is intended or should be inferred.


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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Huiyan Ma
    • 1
  • Colin K. Hill
    • 2
  • Leslie Bernstein
    • 3
  • Giske Ursin
    • 4
    • 5
    Email author
  1. 1.Institute for Health Promotion and Disease Prevention Research, Keck School of MedicineUniversity of Southern CaliforniaAlhambraUSA
  2. 2.Department of Radiation Oncology, Keck School of MedicineUniversity of Southern California/Norris, Comprehensive Cancer CenterLos AngelesUSA
  3. 3.Department of Preventive Medicine, Keck School of MedicineUniversity of Southern California/Norris, Comprehensive Cancer CenterLos AngelesUSA
  4. 4.Department of Preventive Medicine, Keck School of MedicineUniversity of Southern California/Norris Comprehensive Cancer CenterLos AngelesUSA
  5. 5.Department of NutritionUniversity of OsloOsloNorway

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