SU-D-204-03: A Study On the Impact of Decreased Breast Compression During Mammography On Perceived Pain, Breast Thickness and Tissue Coverage

Abstract

Purpose: To investigate the impact of decreasing mechanical breast compression during mammography on perceived pain, compressed breast thickness and tissue coverage. Methods: In this IRB-approved, HIPAA-compliant study 72 women with prior mammograms were recruited to undergo positioning for both the cranio-caudal (CC) and medio-lateral oblique (MLO) views on a digital mammography/breast tomosynthesis system. One breast of each subject was compressed to four levels, including standard full compression for mammography. At each level of compression we recorded: (a) force in lb, (b) breast thickness in cm, (c) perceived pain (Rating: 0 (no-pain) -10 (severe pain)), and (d) relative tissue coverage. Video recording was used to document compression thickness and force displayed by the imaging system, in addition to the research technologist's and participant's voice input regarding the tissue coverage measured on an adhesive ruler placed on the breast and perceived pain rating, respectively. Results: On average, perceived pain to the subjects were reduced by 1.53 and 1.75 points in the CC and MLO views, respectively, in the pain ratings scale by reducing the compression force by one level, while the thickness of the compressed breast increased by an average of 0.02 and 0.09 cm, respectively. At this reduced compression step, there was no change in tissue coverage. Additional reductions in compression force resulted in 8.6% and 11.3% of compressions too low to adequately immobilize the breast, making them clinically impractical. Conclusion: Adequate CC and MLO view acquisitions may be possible with a reduction of compression force by approximately half, resulting in a significant and substantial reduction in perceived pain with no clinically significant change in breast thickness and tissue coverage. Considerably reducing the compression force used for mammography and breast tomosynthesis imaging and therefore reducing the pain perceived by the patients appears to be feasible. Ioannis Sechopoulos is consultant for Fuji Medical Systems USA.