New device may ease mammography discomfort

November 25, 2014

CHICAGO - Researchers have developed a new device that may result in more comfortable mammography for women. According to a study being presented next week at the annual meeting of the Radiological Society of North America (RSNA), standardizing the pressure applied in mammography would reduce pain associated with breast compression without sacrificing image quality.

Compression of the breast is necessary in mammography to optimize image quality and minimize absorbed radiation dose. However, mechanical compression of the breast in mammography often causes discomfort and pain and deters some women from mammography screening.

An additional problem associated with compression is the variation that occurs when the technologist adjusts compression force to breast size, composition, skin tautness and pain tolerance. Over-compression, or unnecessarily high pressures during compression, is common in certain European countries, especially for women with small breasts. Over-compression occurs less frequently in the United States, where under-compression, or extremely low applied pressure, is more common.

"This means that the breast may be almost not compressed at all, which increases the risks of image quality degradation and extra radiation dose," said Woutjan Branderhorst, Ph.D., researcher in the Department of Biomedical Engineering and Physics at the Academic Medical Center in Amsterdam.

Overall, adjustments in force can lead to substantial variation in the amount of pressure applied to the breast, ranging from less than 3 kilopascals (kPa) to greater than 30 kPa.

Dr. Branderhorst and colleagues theorized that a compression protocol based on pressure rather than force would reduce the pain and variability associated with the current force-based compression protocol. Force is the total impact of one object on another, whereas pressure is the ratio of force to the area over which it is applied.

The researchers developed a device that displays the average pressure during compression and studied its effects in a double-blinded, randomized control trial on 433 asymptomatic women scheduled for screening mammography.

Three of the four compressions for each participant were standardized to a target force of 14 dekanewtons (daN). One randomly assigned compression was standardized to a target pressure of 10 kPa.

Participants scored pain on a numerical rating scale, and three experienced breast screening radiologists indicated which images required a retake. The 10 kPa pressure did not compromise radiation dose or image quality, and, on average, the women reported it to be less painful than the 14 daN force.

The study's implications are potentially significant, Dr. Branderhorst said. There are an estimated 39 million mammography exams performed every year in the U.S. alone, which translates into more than 156 million compressions. Pressure standardization could help avoid a large amount of unnecessary pain and optimize radiation dose without adversely affecting image quality or the proportion of required retakes.

"Standardizing the applied pressure would reduce both over- and under-compression and lead to a more reproducible imaging procedure with less pain," Dr. Branderhorst said.

The device that displays average pressure is easily added to existing mammography systems, according to Dr. Branderhorst.

"Essentially, what is needed is the measurement of the contact area with the breast, which then is combined with the measured applied force to determine the average pressure in the breast," he said. "A relatively small upgrade of the compression paddle is sufficient."

Further research will be needed to determine if the 10 kPa pressure is the optimal target.

The researchers are also working on new methods to help mammography technologists improve compression through better positioning of the breast.
-end-
Co-authors on the study are Jerry E. de Groot, M.S., Mireille Broeders, Ph.D., Cornelis A. Grimbergen, Ph.D., and Gerard J. den Heeten, M.D., Ph.D.

Note: Copies of RSNA 2014 news releases and electronic images will be available online at RSNA.org/press14 beginning Monday, Dec. 1.

RSNA is an association of more than 54,000 radiologists, radiation oncologists, medical physicists and related scientists, promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill. (RSNA.org)

For patient-friendly information on mammography, visit RadiologyInfo.org.

Radiological Society of North America

Related Mammography Articles from Brightsurf:

AI tool improves breast cancer detection on mammography
Artificial intelligence (AI) can enhance the performance of radiologists in reading breast cancer screening mammograms, according to a new study.

Mammography screening saves lives also in older age
Mammography, which is an x-ray picture of the breast, is efficient also for women over the age of 70.

Six-month follow-up appropriate for BI-RADS 3 findings on mammography
Women with mammographically detected breast lesions that are probably benign should have follow-up surveillance imaging at six months due to the small but not insignificant risk that the lesions are malignant, according to a new study.

Tomosynthesis outperforms digital mammography in five-year study
A new study has found that the advantages of digital breast tomosynthesis (DBT) over digital mammography (DM), including increased cancer detection and fewer false positive findings, are maintained over multiple years and rounds of screening.

More women in US receive 3D mammography but disparities remain
Use of 3D mammography, an advanced form of breast cancer screening, has risen rapidly in recent years, according to Yale researchers in a new study.

Managing architectural distortion on mammography based on MR enhancement
High negative predictive values (NPV) in mammography architectural distortion (AD) without ultrasonographic (US) correlate or magnetic resonance imaging (MRI) enhancement suggests follow-up rather than biopsy may be safely performed, according to a study to be presented at the ARRS 2019 Annual Meeting, set for May 5-10 in Honolulu, Hawaii.

Older women benefit significantly when screened with 3D mammography
Mammography remains an effective method for breast cancer screening in women ages 65 and older, with the addition of a 3D technique called tomosynthesis improving screening performances even more, according to a new study.

3D mammography significantly reduces breast biopsy rates
The use of digital breast tomosynthesis, also known as 3D mammography, may significantly reduce the number of women who undergo breast biopsy for a non-cancerous lesion following an abnormal mammogram, according to a new study.

Digital mammography increases breast cancer detection
The shift from film to digital mammography increased the detection of breast cancer by 14 percent overall in the United Kingdom without increasing the recall rate, according to a major new study.

New study supports mammography screening at 30 for some women
A new, large-scale study of more than 5 million mammograms found that annual mammography screening beginning at age 30 may benefit women with at least one of three specific risk factors: dense breasts, a personal history of breast cancer or a family history of breast cancer.

Read More: Mammography News and Mammography Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.