Monochromatic X-Ray: The future of breast imaging?

A new, “disruptive” radiographic technology—monochromatic x-ray—has the potential to reduce mammographic radiation dose by five to ten times, decrease breast compression around 50%, and provide more accuracy for dense and thick breasts while maintaining image quality, found a study published online September 14, 2021, in the European Journal of Radiology.

“Lowering radiation dose by a factor of 5 to 10 while maintaining image quality implies a major reduction in total exposure from breast cancer screening and dramatically less risk of radiation-induced cancers in at-risk women. The high SNRs [signal-to-noise ratio] for very thick breast phantoms provide strong evidence that screening with lower breast compression is possible while maintaining image quality,” wrote authors Dr. Michael Fishman, M.D., of Boston University,  and Dr. Madan Rehani, Ph. D., of Massachusetts General Hospital.

Dense breasts occur in 40% of women, who face a cancer risk one-and-a-half times greater than average, with a possible six-fold lifetime risk, according to the authors’ research. Women with dense breasts also typically have later-stage breast cancer when it is detected. This new technology can more accurately detect cancer in dense breasts at earlier stages, leading to more successful outcomes for women with dense breasts.


Michael D.C. Fishman, Madan M. Rehani. Monochromatic X-rays: The future of breast imaging. European Journal of Radiology. November 2021 Published online by Elsevier September 18, 2021. Accessed October 11, 2021, at

Allegretto, Amerigo. Could monochromatic x-ray be the future of breast imaging? September 22, 2021. Accessed October 11, 2021, at

BI-RADS 3 Image
Not a monochromatic x-ray—illustrative only. See the EJR article for images.