One of the most important factors in determining the success of a screening programme is screening uptake 1,2 and the causes of any non-uptake are multifactorial. A systematic review(2013) indicated that between 47,000 and 77,000 women do not re-attend for breast screening in a year due to pain directly related to a previous mammogram3. Pain from mammography can arise from the application of compression force3.It has been demonstrated that the position of the breast under thecompression paddle can affect the amount of pressure in different...

Building on previous studies12,13 this retrospective evaluation of practitioner compression force variation was conducted over a six year screening cycle in three screening units in the North of England. To exclude mammography machine breast readout inaccuracies14 data was gathered from one mammogram machine at each location all operating within NHSBSP and manufacturer specifications15,16. Analogue images were utilised - NHSBSP screening sites had not been converted to digital technology for a six year period at the time of the study. Clients were selected using consecutive stratified...

Practitioner Variability20: The mean number of clients imaged by all practitioners at each site was assessed (Figure One and Two) by analysis of variance (ANOVA): Significant difference (p<0.0001) between sites ‘one and three’, and ‘two and three’. This holds true within each BI-RADS grade. Sites one and two demonstrated no significant difference (CC p>0.5, MLO p> 0.1). This holds true within each BI-RADS grade. Compression Force20: First and third quartile results at all sites were analysed: Significant difference (p<0.0001) between sites ‘one and three’ and...

DEMONSTRATED IMPACT ON CLIENT EXPERIENCE We have demonstrated that practitioners across three breast screening sites behave differently in the application of compression force when undertaking mammography. Two of the three sites demonstrate variability. Variability within these two sites and between the three sites could result in variations in image quality, radiation dose, re-attendance rates and client experience20. IMPACT ON MAMMOGRAPHY IMAGES Direct comparison between images on successive screens is vital to ensure accurate visualisation of subtle changes within the breast. We have demonstrated that compression...

Claire Mercer qualified as a Radiographer in 1995 from S. Martin’s College, Lancaster. She worked in Bolton Hospital for 5 years as a Radiographer and progressed into the field of Mammography in 2000. She developed into an advanced practitioner and QA Radiographer in 2004, followed by Superintendent in 2006. She completed her MSc with distinction in Advanced Medical Imaging in 2011. The following year Claire was appointed into the post of Lead Radiographer for Breast Imaging at the Nightingale Centre & Genesis Prevention Centre at...

Marmot M, Altman DG, Cameron DA, Dewer JA, Thompson SG, Wilcox M. The benefits and harms of breast cancer screening: an independent review. The Lancet 2012; 380 (9855): 1778-86 Weller DP, Campell C. Br J Cancer. 2009 Dec 3;101 Suppl 2:S55-9. doi: 10.1038/sj.bjc.6605391.Uptake in cancer screening programmes: a priority in cancer control. Whelehan P Evans A, Wells M, Macgillivray S. The effect of mammography pain on repeat participation in breast cancer screening: A systematic review. Breast 2013 Aug:22(4) 389-94 Smith H, Hogg P, Maxwell A,...