Abstract
There is evidence that low-energy x-rays as used in mammography have an increased biological effectiveness relative to higher-energy photons. However, the RBE values are not large, probably less than 2. Thus it is unlikely that the radiation risk alone could prove to be a ''show stopper'' regarding screening mammography because, for older women, the benefit is likely to considerably outweigh the radiation risk. Nevertheless, the RBE for low-energy x-rays might reasonably be taken into account when assessing the recommended age to commence such annual screening.
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