A 6 year study of mammographic compression force : practitioner variability within and between screening sites

Mercer, CE; Szczepura, K; Kelly, J; Millington, S; Denton, D; Borgen, R; Hilton, B; Hogg, P

Abstract

Background
The application of compression force in mammography is more heavily influenced by the practitioner rather than the client. This can affect client experience, radiation
dose and image quality. This research investigates practitioner compression force variation over a 6 year screening cycle in three different screening units.

Methods:
Recorded data included: practitioner code, applied compression force(N), breast thickness(mm), BI-RADS® density category. Exclusion criteria included: previous
breast surgery, previous/ongoing assessment, breast implants. 975 clients (2925) client visits, 11,700 mammogram images) met inclusion criteria across three sites.
Data analysis assessed practitioner variation of compression force and breast thickness.

Results:
Practitioners across three breast screening sites behave differently in the application of compression force. Two of the three sites demonstrate variability within
themselves, though they demonstrated no significant difference in mean, first and third quartile compression force and breast thickness values CC(p>0.5), MLO(p>0.1)
between themselves. However, the third site (where mandate dictates a minimum compression force is applied) greater consistency was demonstrated; a significant
difference in mean, first and third quartile compression force and breast thickness values(p<0.001) was demonstrated between this site and the other two sites.

Conclusion:
Stabilisation of variations in compression force may have a positive impact on image quality, radiation dose reduction, re-attendance levels and potentially cancer detection. The large variation in compression forces could negatively impact on client experience between the units and within a unit.
Further research is required to establish best practice guidelines for compression force within mammography.
Keywords: Compression force, Breast compression, Compression variability

• Journal Article Type: Article
• Acceptance Date: Jul 7, 2014
• Online Publication Date: Jul 29, 2014
• Publication Date: Feb 1, 2015
• Deposit Date: Nov 10, 2015
• Publicly Available Date: Oct 17, 2018
• Journal: Radiography
• Print ISSN: 1078-8174
• Publisher: Elsevier
• Volume: 21
• Issue: 1
• Pages: 68-73
• DOI: https://doi.org/10.1016/j.radi.2014.07.004
• Publisher URL: http://dx.doi.org/10.1016/j.radi.2014.07.004
• Related Public URLs: http://www.sciencedirect.com/science/journal/10788174