Keywords:
Performed at one institution, Not applicable, Prospective, Quality assurance, Screening, Mammography, Breast
Authors:
M. KINOSHITA1, H. Goto1, M. Sakamoto1, H. Matuzuki1, D. Nagase1, A. Manabe1, R. ISHII2, J. Ikeda1; 1Ashiya/JP, 2Habikino/JP
DOI:
10.26044/ecr2020/C-00113
Purpose
Breast compression in mammography is important in reducing the absorbed dose to the breast and improving the image quality [1][2]. However, many patients experience some degree of discomfort or pain during mammography; some patients even postpone or avoid mammography because of the pain associated with the exam. Previous studies have shown that the perception of discomfort or pain associated with mammography may dissuade women from taking the exam [3][4]. The Mammography Quality Standards Act indicates that “compression shall be between 111 and 200 N” [5]. The EUREF guidelines indicate that breast compression “should be firm but tolerable” [6]. Although breast compression is a key factor in image quality and guidelines do exist, these guidelines may not be adequate or precise enough to identify optimal breast compression levels. Therefore, any technique which reduces some of the discomfort or pain during mammography would be very beneficial to patients and could have a positive impact on compliance.
In January of 2019, a newly developed compression control system named “Comfort Comp System” (CCS) was introduced to reduce discomfort and pain experienced by mammography patients. In physics, hysteresis is defined as the dependence of the state of a system on its history [7]. When applying and then releasing pressure to the breast, this phenomenon of hysteresis takes place in which once pressure is applied and then released there is a period of lag before the object under pressure returns to its original state. The CCS takes advantage of this interval of hysteresis by reducing the time in which the breast is compressed to the maximum pressure of 140N [8], therefore reducing pain compared to the conventional method.
This process of hysteresis limits any changes in the compressed breast thickness (CBT) when the pressure is released, therefore leaving the image quality almost unchanged. The CCS was set so that the decompression would stop once it reached 80N or once the reverting increment of CBT reached a maximum of 3 mm (Fig.1). In this way, the CCS offers the potential to maintain comparable image quality while also reducing discomfort or pain in the patients. It has already been reported that the image quality remained identical even when the CBT changed by 3 mm [9].
The purpose of this study was two-fold. First, to evaluate the impact of the CCS on pain reduction and secondly to evaluate the influence of breast volume and composition on the effectiveness of the CCS.