ARRS 2022 Abstracts

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E1584. Patient vs Technologist Controlled Mammography Compression Using Standard Equipment: A Prospective Comparative Study of Patient Discomfort
Authors
  1. Alexis Davenport; Henry Ford Hospital
  2. David Pinkney; Henry Ford Hospital
  3. Sai Kilaru; Central Michigan University
  4. Sabala Mandava; Henry Ford Hospital
  5. Amy Williams; Henry Ford Hospital
  6. Amy Tang; Henry Ford Hospital
Objective:
Breast compression is an essential component of high-quality mammography, as it increases reader sensitivity and reduces radiation dose. Unfortunately, compression can be uncomfortable and may dissuade women from following screening recommendations. Allowing patients to assist with compression has been considered as a way to lessen the pain and anxiety associated with mammography. Previous studies have demonstrated how patient-assisted compression (PAC) can reduce pain experienced during mammography; however, these studies utilized remote-controlled compression equipment, which is expensive and not available at most breast imaging centers. The purpose of this study was to assess whether PAC utilizing standard mammography equipment reduces women’s experienced level of pain.

Materials and Methods:
IRB approval was obtained. Females aged 40–90 years who presented for their screening mammogram from February 2020 to June 2021 were voluntarily enrolled. Women who were pregnant, breastfeeding, had a prior mastectomy, had not had a mammogram in the past 5 years, or had breast implants were excluded. Subjects were randomly assigned to one of two study arms. Each subject underwent bilateral digital or combination digital and tomosynthesis screening mammography. In the first arm, the subject assisted with compression using a manual knob after the technologist positioned the breast and initiated light compression (PAC). In the second arm, the technologist alone controlled the level of compression using routine technique (technologist controlled compression, TCC). Both groups completed a survey prior to and following the mammogram to assess their expected and experienced level of pain. The surveys included a State-Trait Anxiety Scale and a 100-mm visual analogue pain scale. Paired t tests were used for comparisons of pre-mammogram and post-mammogram data within a study arm. Two sample t tests were used for comparisons between study arms.

Results:
A total of 382 subjects were enrolled. Between the two study groups, there was no statistically significant difference between the expected level of pain prior to the mammogram (p = 0.97). Although both study groups reported a lower level of pain than was expected, the difference was greater for the PAC group (p < 0.0001). Additionally, the PAC group reported a significantly lower level of experienced pain during the mammogram compared to the TCC group (p = 0.014). Of note, no technical repeats were recommended for the PAC mammograms upon review by a radiologist.

Conclusion:
Women who assisted with breast compression during screening mammography utilizing standard equipment reported less pain compared to women who underwent routine mammography with technologist controlled compression. This study is the first known of its kind to utilize standard manual knob equipment available on all mammography units rather than remote controls. We believe lessening the pain and anxiety associated with mammography could have a favorable effect on patient adherence to breast cancer screening recommendations.