RRIMS: Radiation Risk In Mammography Screening - a novel model for predicting the lifetime dose and risk of radiation-induced breast cancer from the first screening visit.

Objectives: Methods: This model training was developed using a large dataset of Hologic images containing a total of 20,232 images from 5,076 visits from 4,154 females. The female's breast characteristics and exposure parameters were extracted from the images to calculate the female's MGD throughout a lifetime of screening from just her first screening visit, using modelling of various parameters and their change through time. Results: This development has ultimately provided a model that uses the female's first screening visit to calculate the received MGD for all ages of potential screening. This has enabled the allocation of females to either a low-, medium-, or high-dose category, ultimately followed by the lifetime effective risk (LER) estimation for any screening attendance pattern. A female in the low-dose category undergoing biennial screening from 50 to 74 years would expect a risk of radiation-induced breast cancer incidence and mortality of 8.64 and 2.61 cases per 100,000 females, respectively. Similarly, a female in the medium- or high-dose category undergoing the same regimen would expect an incidence and mortality risk of 11.76 and 3.55, and 15.08 and 4.55 cases per 100,000 females, respectively. Conclusions: This novel approach of establishing a female's dose profile and lifetime risk from a single visit will further assist females in their informed consent on breast screening attendance and help inform policy-makers when exploring the benefits and drawbacks of various screening patterns and frequencies. Advances in knowledge: RRIMS is a novel tool that enables the assessment of a female's lifetime dose and risk profile using only the information from her first screening visit.