Making Mammograms Less Painful

Mammographic compressions can be standardized to lower pressure without compromising radiation dose and apparent image quality, according to a study being presented this week at the annual meeting of the Radiological Society of North America (RSNA).

Researchers from the Netherlands developed a new device that could minimize the discomfort some women feel during mammography and undertook a double-blinded randomized controlled trial to determine if a lower compression force for mammograms would provide acceptable image quality while making the examination less painful for the patient.

According to the researchers, over-compression, or unnecessarily high pressures during compression is common in certain European countries, especially for women with small breasts. It is less common 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,” researcher Woutjan Branderhorst, PhD, department of biomedical engineering and physics, Academic Medical Center in Amsterdam, said in a release.

A total of 433 asymptomatic women underwent screening mammography for this study. The new device displays the average pressure during compression and studied its effects. 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.

The participants scored pain on a numerical rating scale, and three experienced breast-screening radiologists indicated which images required a retake.

The results showed that 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.

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

The researchers pointed out that further research will be needed to determine if the 10 kPa pressure is the optimal target and they are also working on new methods to help mammography technologists improve compression through better positioning of the breast.