Can You Have a Mammogram with a Thyroid Shield?
When undergoing or conducting diagnostic imaging procedures like mammograms, you may hear about how X-rays emit scatter radiation.
Shielding like a lead apron or thyroid shield is commonly worn by clinicians (and sometimes patients) during diagnostic imaging or interventional surgery to protect critical organs. However, there’s some debate about the necessary shielding equipment for safety during certain procedures.
Do you need to shield the thyroid during a mammogram? We’ll detail all the information here to help your team make effective and safe choices.
Do Mammograms Affect the Thyroid?
Most studies show that the radiation dose the thyroid receives during a mammogram is minimal for patients.
The American Cancer Society states that the average dose throughout the body during a mammogram is 0.4 mSv. A study from the American Journal of Roentgenology also mentioned that even a dose of 0.4 mSv directly to the thyroid was negligible for patients receiving an annual or biannual exam.
Both of those studies and a statement from the American Thyroid Association say that it isn’t necessary for patients to wear a thyroid shield for mammograms due to the overall low one-time dose they receive.
Shielding Needs Are Different for Clinicians
The needs of clinicians regularly conducting X-rays, mammograms, or interventional procedures daily are a bit different. While a mammogram is a low-dose procedure, being in a room with a radiation dose of 0.4 mSv regularly can add up for clinicians.
OSHA’s recommended quarterly limit for the radiation dose healthcare workers can receive is 1.25 rem or (12.5 mSv). On an annual basis, that’s 5 rem or 50 mSv. Depending on the number of mammograms clinicians conduct, 0.4 mSv (or even a fraction of that when outside the direct beam) can add up quickly.
Therefore, wearing lead aprons or thyroid guards for X-rays and mammograms may be a good idea for medical staff members to reduce their exposure. That’s especially crucial for organs like the thyroid, which are highly sensitive to ongoing radiation exposure.
There can be dangers of mammogram radiation or interventional surgery radiation that clinicians get exposed to frequently without proper protection. A study in 2020 showed that ongoing ionizing radiation exposure to the thyroid may cause a greater risk of cancer, hypothyroidism, or autoimmune responses.
It’s best to consult your organization’s radiation safety officer to determine the proper personal protective equipment (PPE) required for specific procedures to remain protected.
What Can Disrupt Your Mammogram?
The National Breast Cancer Foundation states that you should avoid applying deodorants, antiperspirants, creams, powders, lotions, perfumes, or other cosmetics to the breasts, chest, or underarms before a mammogram because it can interfere with the results.
The American Thyroid Association also noted reported cases where wearing a thyroid collar during a mammogram resulted in suboptimal imaging. This is another reason why clinical studies may advise against its use for patients.
However, clinicians wearing thyroid collars or lead aprons in the same room as the mammogram won’t affect the results, making it safe and reasonable to shield from scatter radiation.
Should the Patient Wear a Thyroid Collar for a Panoramic Exposure?
Patients may also wonder about wearing a thyroid guard at the dentist, such as during 2-D panoramic X-rays that capture an image of the mouth.
The American Dental Association (ADA) has recently updated its X-ray shielding requirements. In February 2024, they stated that patients no longer need to wear thyroid collars during radiographic exams as long as dental offices are using modern equipment that’s properly calibrated. Modern dental X-rays emit a much lower dose of radiation.
However, shielding like thyroid collars and lead aprons are still essential in medical settings, especially for clinicians conducting procedures regularly. Medical X-rays, C-arms, and fluoroscopy emit higher doses of radiation that require proper protection for clinicians and sometimes patients if it doesn’t interfere with the procedure.
When Should You Not Have a Mammogram?
It’s common to wonder when to worry about a mammogram. The American Cancer Society’s guidelines state that women under 40 usually don’t need to get one unless:
You have a family history of breast cancer
Have had breast cancer treatment
Have certain health conditions like Cowden syndrome, Li-Fraumeni syndrome, or Bannayan-Riley-Ruvalcaba syndrome that put you at higher risk of breast cancer
Their recommendations state that individuals meeting those criteria or women aged 40-45+ should get a mammogram at least once every two years, or once per year if they have certain risk factors.
Conclusion: When Thyroid Collars Are Needed and Best Practices
Based on clinical research and medical safety guidelines, patients usually don’t need to wear a thyroid collar for a mammogram, and it may not be recommended since it could interfere with the image.
However, it may be a good idea for clinicians to wear shielding like lead aprons and thyroid collars during mammograms.
Additionally, research from governing organizations like AORN and the CDC shows that shielding is essential for high-dose procedures like C-arm guided fluoroscopy.
When using shielding equipment, follow best practices, such as properly storing lead garments, inspecting them for damage annually using X-ray scanning, and deep cleaning and disinfecting them quarterly.
Damages to lead garments reduce their effectiveness, and a study by Dr. Jaber also showed that improper cleaning can lead to them harboring harmful microorganisms like Staphylococcus aureus, tinea species (ringworm), and MRSA. Therefore, proper maintenance is crucial for health and safety.
Properly Maintain Your Protective Garments with Our Services at RCS
PPE like lead aprons and thyroid shields are essential to shield clinicians in many procedures. However, it can often be costly and time-consuming for healthcare facilities to perform radiographic inspections, deep cleaning, and repairs to maintain them. We can help at Radiological Care Services (RCS).
Our services include:
Quarterly garment cleaning and disinfection
Annual X-ray inspections
Garment repair
Garment disposal
Inventory management with our RADCOMPLY™ software
We make the process efficient and easy to manage each step of the way so you can focus on providing great patient experiences while knowing your garments are clean and safe.
Contact us today to learn more.
