Screening and X-rays: All equal?

Radiosusceptibility to cancer, known since decades and concerning probably 10 to 20% of the population, is barely considered in breast cancer screening by X-ray mammography. It has really emerged with the issue of screening in women with high family risk of breast cancer. While a link between breast cancer and low dose ionizing radiation was difficult to establish in the general population, epidemiology has shown a link in BRCA1/2 mutated women. On the other hand, radiation biology has identified indicators of radiosusceptibility at low doses at the cellular level and in subgroups of cancer prone people. Several functional assays of signalization and repair pathways of DNA damage are today available and susceptible to demonstrate this individual abnormal response to X-rays. (C) 2018 Elsevier Masson SAS. All rights reserved.