Abstract / Summary
Abstract Background Mammography is a key imaging modality for early breast cancer detection, but it involves exposure to ionizing radiation. This study aimed to establish local Diagnostic Reference Levels (LDRLs) for 2D and 3D mammography within Emirates Health Services (EHS) facilities to optimize radiation doses and enhance patient safety. Methods A descriptive cross-sectional study was conducted across nine EHS facilities from February 2023 to June 2025. Data from 1184 women undergoing screening and diagnostic mammography were analyzed. Standard craniocaudal (CC) and mediolateral oblique (MLO) projections were acquired using full-field digital mammography (2D, FFDM) and digital breast tomosynthesis (3D, DBT) systems with automatic exposure control (AEC). Only examinations with a compressed breast thickness (CBT) of 5.0 ± 0.5 cm were included to standardize radiation dose assessment. Extracted parameters included patient age, tube voltage (kVp), tube current–time product (mAs) and mean glandular dose (MGD). Local DRLs were defined as the 75th percentile of the MGD distribution for each projection and modality. Results For 2D mammography, mean ± standard deviation MGD values were 1.05 ± 0.51 mGy (CC) and 1.15 ± 0.57 mGy (MLO). For 3D mammography, mean ± standard deviation MGD values were higher at 1.87 ± 0.44 mGy (CC) and 2.08 ± 0.37 mGy (MLO). The resulting local DRLs were 1.30 mGy for CC and 1.46 mGy for MLO. EHS facility-level analysis indicated uniform dose distribution across all sites. Discussion The observed differences between 2D and 3D mammography doses reflect the inherently higher radiation requirements of tomosynthesis for volumetric imaging, consistent with international literature. Uniform distribution across EHS facilities suggests standardized protocols and effective quality control measures. The established LDRLs provide a practical tool for dose optimization, enabling radiology teams to benchmark their practices and identify potential areas for dose reduction without compromising image quality. Moreover, these findings support the development of a UAE national mammography dose registry, promoting patient safety, regulatory compliance, and continuous monitoring of radiation exposure trends. Conclusion The study establishes local DRLs for mammography within EHS facilities, confirming that current practices are optimized for patient radiation safety while maintaining diagnostic quality. These LDRLs provide benchmarks for national dose optimization, support regulatory oversight, and form the foundation for a comprehensive UAE national mammography dose registry.