Self-compression during mammograms reduces patient anxiety

Self-compression during screening mammograms improves the overall patient experience, according to a new study published in the Journal of Breast Imaging. Could this help keep women up to date with their recommended screening schedule?  

“Adequate compression is necessary to reduce motion and scatter radiation, thereby optimizing image quality and reducing the radiation dose to the breast,” wrote Brian N. Dontchos, MD, department of radiology at Massachusetts General Hospital in Boston, and colleagues. “Unfortunately, the majority of women perceive compression during mammography as painful, with a subset describing the exam as moderately to extremely painful, and pain experienced during mammograms has been identified as a significant deterrent to subsequent mammographic screening.”

From February to July 2018, women who underwent screening with a 2D synthetic mammography/digital breast tomosynthesis solution at a single facility were offered the choice of operating a patient-assisted compression (PAC) device or undergoing traditional technologist-controlled compression (TC).

“This first PAC device was approved by regulatory authorities in the USA and European Union in 2017,” the authors explained. “It is approximately the size of a computer mouse and it communicates wirelessly with the mammography unit. It has two buttons: a ‘plus’ button to increase compression, and a ‘minus’ button to decrease compression.”

Patients were surveyed about the experience following their mammogram, using a scale of 1 to 5 to answer questions about anxiety and pain. Women who used the PAC were asked additional questions about how they felt about the option before and after the examination occurred.

A total of 148 patients completed a survey following their screening mammogram. Overall, 33.8% of patients chose to use the PAC, and 73% of those women preferred the experience over their prior mammogram when no PAC was used. After the researchers controlled their analysis for patient age and breast density, there was a “significant decrease in anxiety” for patients who chose the PAC compared to those who chose TC.

In addition, 92% of patients who chose the PAC device said “not at all” or “not really” when asked if they felt afraid or anxious about this new compression technique. And 77% of those patients said they were “somewhat” or “very much” more likely to choose the PAC device in the future

No significant differences between the two compression methods were detected when it came to compression thickness or glandular dose. Also, women who chose the PAC device had more compression force than women who did not.

“We present evidence supporting the clinical use of a PAC device for screening mammograms that improves patient experience and maintains image quality for women opting for the device,” the authors concluded. “The option of PAC has the potential to lessen deterrents and improve patient adherence to screening mammography.”