A novel approach to mammographic breast compression: Improved standardization and reduced discomfort by controlling pressure instead of force

Abstract

In a standard 18 daN force-controlled compression protocol, the authors observed an average pressure of 21.3 kPa±54% standard deviation for CC compressions and 14.2 kPa±32% for MLO compressions. Women with smaller breasts endured higher pressures and experienced more pain, as indicated by a significant negative correlation (ρ=-0.19, p<0.01) between contact area and pain score. Multivariate regression showed that contact area is a strong and significant predictor for severe pain (ORNRS≥7 (CC)=0.10/dm2, p<0.05), as is the case with any pain already present before compression (ORNRS≥7 (CC)=1.61 per NRS-point, p<0.05). Model estimations showed that mammographic breast compression with a standardized pressure of 10 kPa, corresponding with normal arterial blood pressure, may significantly reduce the number of severe pain complaints with an average increase in breast thickness of 9% for small breasts and 2% for large breasts. For an average 16.5% thickness difference in prior-current mammogram pairs, the authors found no differences in image quality and AGD CONCLUSIONS: Model estimations and an observer study showed that pressure-controlled mammographic compression protocols may improve standardization and reduce discomfort with limited effects on image quality and AGD.