Practitioner compression force variation in mammography : a 6 year study

Mercer, CE; Hogg, P; Szczepura, K; Denton, E

Abstract

The application of breast compression in mammography may be more heavily influenced by the practitioner
rather than the client. This could affect image quality and will affect client experience. This study builds on
previous research to establish if mammography practitioners vary in the compression force they apply over a six year period.

This longitudinal study assessed 3 consecutive analogue screens of 500 clients within one screening centre in
the UK. Recorded data included: practitioner code, applied pressure (daN), breast thickness (mm), BI-RADS®
density category and breast dose. Exclusion criteria included: previous breast surgery, previous/ongoing
assessment, breast implants. 344 met inclusion criteria. Data analysis: assessed variation of compression force
(daN) and breast thickness (mm) over 3 sequential screens to determine whether compression force and breast
thickness were affected by practitioner variations.
Compression force over the 3 screens varied significantly; variation was highly dependent upon the practitioner
who performed the mammogram. Significant thickness and compression force differences over the 3 screens
were noted for the same client (<0.0001). The amount of compression force applied was highly dependent upon
the practitioner. Practitioners fell into one of three practitioner compression groups by their compression force
mean values; high (mean 12.6daN), intermediate (mean 8.9daN) and low (mean 6.7daN).

For the same client, when the same practitioner performed the 3 screens, maximum compression force variations
were low and not significantly different (p>0.31). When practitioners from different compression force groups
performed 3 screens, maximum compression force variations were higher and significantly different (p<0.0001).

The amount of compression force used is highly dependent upon practitioner rather than client. This has
implications for radiation dose, patient experience and image quality consistency.

• Journal Article Type: Article
• Acceptance Date: Jun 2, 2013
• Online Publication Date: Jun 24, 2013
• Publication Date: Aug 1, 2013
• Deposit Date: Nov 10, 2015
• Publicly Available Date: Sep 22, 2017
• Journal: Radiography
• Print ISSN: 1078-8174
• Publisher: Elsevier
• Volume: 19
• Issue: 3
• Pages: 200-206
• DOI: https://doi.org/10.1016/j.radi.2013.06.001
• Publisher URL: http://dx.doi.org/10.1016/j.radi.2013.06.001
• Related Public URLs: http://www.sciencedirect.com/science/journal/10788174