European Radiology: How can patient adherence to mammography screening be improved?

According to statistics, breast cancer is still the cancer with the highest incidence among women and is a major public health problem
.
Therefore, breast cancer screening programs were established to detect potentially curable diseases and reduce mortality
.
However, there must be a high rate of population participation
.

Mammography is the imaging modality of choice for breast cancer screening, which can detect smaller lesions, better treatment options, and higher survival ratesHowever, although the benefits of mammogram have been proven, However, many women miss a follow-up test
for fear of the discomfort of repeating previous mammograms.

Mammogram requires compression of the mammography can cause varying degrees of discomfort or pain
.
However, this procedure is necessary to avoid motion artifacts and reduce breast thickness, which is essential
to obtain high-quality images.
In addition, lower breast thickness helps reduce tissue overlap and improve image contrast
.

Currently, there are no standardized guidelines to define the optimal level
of oppression.
The measurement parameter currently available in mammography systems is compression force, without taking into account the size of the
mammary glands.
Several methods have been clinically proposed to minimize pain caused by breast compression and to increase revisit rates for screening programs
.
One way to do this is to let women control the pressure on their mammary glands themselves, which may increase their satisfaction and the likelihood of repeated mammograms without affecting image quality Volume
.

Recently, a study published in the journal European Radiology evaluated the value of breast self-compression in improving the technical parameters of compression and the experience of female patients with the process, providing technical support
for improving the compliance of female screeners with mammogram and further improving follow-up rate.

This study conducted a prospective randomized controlled study at our institution involving a total of 448 asymptomatic women
aged 50 to 69 years.
Mammogram consists of two bilateral views
.
In each woman, one breast is examined with SC and the other with PAC
.
The pattern used by each breast is selected according to a
random list.
Compression force, breast thickness, and average glandular dose were obtained for each of the 1792 images.

The level of discomfort and experience
after mammogram was also recorded using a predefined questionnaire.

The compression force obtained with PAC is higher than that obtained with SC (99.
27 N vs 83.
25 N, P < 0.
001).

The breast thickness mode (56.
11 mm vs 57.
52 mm, p = 0.
015) and glandular dose (1.
34 mGy vs 1.
37 mGy, p = 0.
018) were lower
in PAC.
PAC had slightly higher discomfort scores (mean 3.
94 vs 3.
69, p = 0.
042), but in satisfaction surveys, more women reported less discomfort caused by PAC
.
In addition, 63.
2% of women (289/448) preferred the PAC model
.

Plot: Density plot of compression parameters and discomfort

This study suggests that PAC mode, as an alternative method in the mammogram process, can enable screeners to achieve higher levels of compression, reduce breast thickness and radiation dose, and improve women's
experience and compliance with mammography programs.

Original source:

Natalia Arenas,Rodrigo Alcantara,Margarita Posso,et al.
Comparison of technical parameters and women's experience between self-compression and standard compression modes in mammography screening: a single-blind randomized clinical trial.
DOI:10.
1007/s00330-022-08835-y