RSNA: New device, compression protocol could ease mammo pain

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 - Retrofit paddle mammography
A retrofit paddle for an existing machine which is currently used in the Academic Medical Center Amsterdam.
Source: RSNA

CHICAGO—While compression of the breast is necessary for mammography, it can be uncomfortable and deter women from screening. However, a study presented at the annual meeting of the Radiological Society of North America (RSNA) focusing on a new device that measures pressure could offer some relief.

Currently, force-based compression protocols are used as opposed to pressure-based protocols, the difference being that force is the total impact of one object on another, while pressure is the ratio of force to area. Researcher Woutjan Branderhorst, PhD, of the Department of Biomedical Engineering and Physics at the Academic Medical Center in Amsterdam, and colleagues thought that a pressure-based protocol might limit the pain and variability experienced with the procedure.

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

The researchers noted that adjustments in force can lead to substantial variation in the amount of pressure, from 3 kilopascals (kPa) to greater than 30 kPa. In the U.S., under-compression is somewhat common, limiting image quality.

Branderhorst and colleagues developed a device that displays the average pressure during compression and studied its effect on patient comfort and image readability. In a double-blind, randomized trial featuring 433 asymptomatic patients, three of four compressions were standardized to a target force of 14 dekanewtons, while one randomly assigned compression was standardized to a pressure of 10 kPa.

On average, the women in the study reported that the 10 kPa pressure compression was less painful than the compressions set to a target force. Three radiologists with experience in breast screening reviewed the images and found the pressure-based protocol did not compromise radiation dose or image quality.

While the study suggests a pressure-based protocol is beneficial, more work will be needed to determine whether 10 kPa is the optimal pressure target to balance both comfort and image quality.