Women find cone-beam breast CT more comfortable than mammography

Women say cone-beam breast CT (CBBCT) is more comfortable than digital mammography, according to new research published in the European Journal of Radiology. For some patient groups, however, this was not the case.

The study’s authors noted that the success of screening mammography “has been established,” but it does have certain limitations, including the physical compression of the patient’s breast.

“The uncomfortable experience of mammography is related to physiological and situational factors,” wrote Haijie Li, department of radiology at Tianjin Medical University in China, and colleagues. “Although compression can reduce the radiation dose, improve image quality, and prevent motion artifacts, it will increase the discomfort of patients.”

During CBBCT, patients lie on the examination table and no compression is required. Does this help patients feel more comfortable during the examination? To find out, authors surveyed more than 400 patients who underwent both CBBCT and mammography from October 2012 to January 2014. Each patient used an 11-point rating scale—the lower the number, the more comfortable the examination was—to grade the two modalities. All patients were at least 35 years old.

Overall, CBBCT was found to be more comfortable than mammography in both contrast-enhanced patient groups and non-enhanced patient groups. It was also more comfortable in patients younger than 44 years old and 45 to 59 years old. For patients 60 years and older, “there was  no significant difference” in comfort ratings.

“Based on the results of our study, the patient’s comfort during the CBBCT examination was shown to be statistically better than the patients’ comfort during mammography,” the authors wrote.

CBBCT was also more comfortable in patients with dense breasts, which Li et al. noted was an important finding.

“Breast density is a primary predictor of breast discomfort during the mammography examination, especially for dense breasts,” the authors wrote. “Thus, the CBBCT could provide for more choices for dense-breasted patients.”

The survey responses also helped researchers learn when mammography is a more comfortable modality for patients. Underweight patients, for example, did find CBBCT to be less comfortable than mammography. 

“The underweight patients could feel uncomfortable in the prone position,” the authors wrote. “The shape of the examination table is lower on the head side and higher on the foot side and has a certain slope, which could increase the patient's discomfort. This finding suggested the patients’ BMI could influence the comfort of CBBCT during the examinations.”