Mammographic compression in Asian women

Abstract

ObjectivesTo investigate: (1) the variability of mammographic compression parameters amongst Asian women; and (2) the effects of reducing compression force on image quality and mean glandular dose (MGD) in Asian women based on phantom study.MethodsWe retrospectively collected 15818 raw digital mammograms from 3772 Asian women aged 35–80 years who underwent screening or diagnostic mammography between Jan 2012 and Dec 2014 at our center. The mammograms were processed using a volumetric breast density (VBD) measurement software (Volpara) to assess compression force, compression pressure, compressed breast thickness (CBT), breast volume, VBD and MGD against breast contact area. The effects of reducing compression force on image quality and MGD were also evaluated based on measurement obtained from 105 Asian women, as well as using the RMI156 Mammographic Accreditation Phantom and polymethyl methacrylate (PMMA) slabs.ResultsCompression force, compression pressure, CBT, breast volume, VBD and MGD correlated significantly with breast contact area (p<0.0001). Compression parameters including compression force, compression pressure, CBT and breast contact area were widely variable between [relative standard deviation (RSD)≥21.0%] and within (p<0.0001) Asian women. The median compression force should be about 8.1 daN compared to the current 12.0 daN. Decreasing compression force from 12.0 daN to 9.0 daN increased CBT by 3.3±1.4 mm, MGD by 6.2–11.0%, and caused no significant effects on image quality (p>0.05).ConclusionsForce-standardized protocol led to widely variable compression parameters in Asian women. Based on phantom study, it is feasible to reduce compression force up to 32.5% with minimal effects on image quality and MGD.

Mammographic compression practices of force‐ and pressure‐standardisation protocol: A scoping review

“…The retained articles consisted of a mixture of quantitative study methods. There were six prospective 8,9,14,20–22 and eleven retrospective studies, 1,6,7,10,12,13,15–17,23,24 with one case–control study 5 . Publication dates ranged from 2004 to 2019, with the last publication being a 2019 retrospective cohort study 24 .…”

“…There were six prospective 8,9,14,20–22 and eleven retrospective studies, 1,6,7,10,12,13,15–17,23,24 with one case–control study 5 . Publication dates ranged from 2004 to 2019, with the last publication being a 2019 retrospective cohort study 24 . Eleven studies were sourced from the Netherlands, 5–8,10,12–14,20,21,23 with one remaining publication originating from Malaysia, 24 two from Norway, 1,22 three from the United Kingdom 15–17 and one from Australia 9 .…”

Breast compression across consecutive examinations among females participating in BreastScreen Norway

“…breast compression observed in our study had an effect of image quality. Studies have reported different effects on image quality with changes in breast compression parameters of this magnitude, [33][34][35][36][37][38] from minimal and no impact on image quality, [33][34][35][36] to considerable and significant effects on image quality. 37,38 conclusions This is the first study investigating breast compression parameters over consecutive screening examinations in BreastScreen Norway.…”

Technical Note: Validation of two methods to determine contact area between breast and compression paddle in mammography

“…Recent publications point out that controlling pressure can be beneficial in terms of reproducibility, pain, radiation dose, image quality, and detectability of breast cancer. [1][2][3][4][5][6][7][8][9][10][11][12][13] For many years, breast compression has been susceptible to subjectivity and thus large variations in the applied pressure. With mammography systems indicating only the force applied by the paddle, but not the area over which the force is distributed, 14 the exerted pressure (force divided by area) could only be estimated based on subjective cues, such as skin tautness or the patient's perceived pain experience.…”

“…Both methods are increasingly often employed to establish the average compression pressure in mammography, for standardization, quality control, and scientific research in a growing number of research groups. 4,5,7,8 …”