Breast compression parameters among women screened with standard digital mammography and digital breast tomosynthesis in a randomized controlled trial

2019 ◽  
Vol 61 (3) ◽  
pp. 321-330 ◽  
Author(s):  
Gunvor Gipling Waade ◽  
Åsne Holen ◽  
Sofie Sebuødegård ◽  
Hildegunn Aase ◽  
Kristin Pedersen ◽  
...  
Keyword(s):  
Digital Mammography ◽  
Controlled Trial ◽  
Digital Breast Tomosynthesis ◽  
Compression Pressure ◽  
Breast Tomosynthesis ◽  
Breast Compression ◽  
Randomized Controlled ◽  
Mean Glandular Dose ◽  
Evidence Based Guidelines ◽  
Breast Thickness

Background No evidence-based guidelines regarding optimal breast compression in mammography exist, neither for standard digital mammography nor for digital breast tomosynthesis. Purpose To compare breast compression parameters and mean glandular dose in a randomized controlled trial with digital mammography versus digital breast tomosynthesis. Material and Methods We used information from 21,729 women aged 50–69 years, who participated in the To-Be trial, as part of BreastScreen Norway, 2016–2017. Information was obtained from the DICOM header and by assessing the images in an automated software for density estimation (VolparaDensity). Using linear regression, we investigated the effect of screening technique on breast compression parameters; compression force (N), compression pressure (kPa), and compressed breast thickness (mm), and mean glandular dose (mGy), by view (craniocaudal [CC] and mediolateral oblique [MLO]). We adjusted for age, breast volume and fibroglandular volume. Results A total of 11,056 (50.9%) women were screened with digital mammography and 10,673 (49.1%) with digital breast tomosynthesis. Adjusted regression analysis showed that women undergoing digital mammography received higher compression forces than women undergoing digital breast tomosynthesis (CC: –4.7 N; MLO: –1.1 N, P < 0.001 for both), higher compression pressure (CC: –1.0 k Pa; MLO: –0.1 kPa, P < 0.001 for both), and higher values of compressed breast thickness in the MLO view (–0.3 mm, P = 0.02). The women undergoing digital mammography received a lower mean glandular dose than women undergoing digital breast tomosynthesis ([+]0.06 mGy, P < 0.001). Conclusion Women undergoing digital breast tomosynthesis received lower compression force, compression pressure, and compressed breast thickness in MLO view, compared to women undergoing digital mammography. Further studies should investigate the impact of breast compression on image quality, screening outcome, and radiation dose for digital mammography and digital breast tomosynthesis in order to establish evidence-based guidelines for breast compression.

Effect of Compression Force and Target or Target/Filter Combination on Mean Glandular Dose for Japanese Women in Full-Field Digital Mammography System

2021 ◽  
Vol 11 (10) ◽  
pp. 2695-2700
Author(s):  
Mie Ishii ◽  
Mai Nakamura ◽  
Rie Ishii ◽  
Keiichi Shida ◽  
Toshikazu Hatada ◽  
...  
Keyword(s):  
Digital Mammography ◽  
Japanese Women ◽  
Compression Pressure ◽  
Full Field ◽  
Breast Compression ◽  
Mean Glandular Dose ◽  
Full Field Digital Mammography ◽  
The Mean ◽  
The Difference ◽  
Breast Thickness

We constructed a mammography database of 807 Japanese women and 2,772 images obtained using five commercial full-field digital mammography (FFDM) devices at four different facilities. Five types of mammography devices fabricated by four manufacturers were used: one with a Mo target (AMULET F), one with Mo and Rh targets (Senographe DS), one with Mo and W targets (AMULET), and two with a W target (MAMMOMAT Fusion and Selenia Dimensions). The purpose of this study was to focus on the mean glandular dose (MGD) in the database and analyze the difference in the MGD of Japanese women radiographed by mammographic devices with different targets or target/filter combinations. Furthermore, we clarify the difference between the displayed and measured MGDs for the three types of mammography devices. The average compression pressure and compression breast thickness of the Japanese women in the mammography in this study were 90.9±21.7 N and 43.3±12.9 mm, respectively. The breast compression pressure slightly varied depending on the facility or FFDM device, while the compression breast thickness decreased with the increase in the compression pressure for all FFDM devices. Differences in breast compression thickness existed depending on the mammography devices. The MGDs of the two types of mammography devices using the W target were smallest (1.335±0.358, 1.218±0.464 mGy). The displayed and measured MGDs of the three types of FFDM devices had a good correlation. However, the difference between the displayed and measured MGDs of the two devices increased with the MGD.

scholarly journals Pressure-based Compression Guidance of the Breast in Digital Breast Tomosynthesis Using Flexible Paddles Compared to Conventional Compression

2020 ◽  
Vol 2 (6) ◽  
pp. 541-551
Author(s):  
Monique G J T B van Lier ◽  
Jerry E de Groot ◽  
Serge Muller ◽  
Gerard J den Heeten ◽  
Kathy J Schilling
Keyword(s):  
Digital Breast Tomosynthesis ◽  
Control Device ◽  
Institutional Review Board ◽  
Target Range ◽  
Compression Pressure ◽  
Breast Tomosynthesis ◽  
Breast Compression ◽  
Institutional Review Board Approval ◽  
Institutional Review ◽  
Breast Thickness

Abstract Objective We investigated the effect of introducing a pressure-based flexible paddle on compression parameters and user and patient experience of digital breast tomosynthesis (DBT) combined with patient-assisted compression or technologist compression. Methods After institutional review board approval, women with a DBT appointment who gave informed consent received pressure-based flexible paddle breast compression. Eight lights on the paddle were illuminated (1.9 kPa per light) as pressure was applied, aiming for an 8–13.9 kPa target range. The compression level was applied by the technologist or the participant utilizing a remote control device. The participant’s and technologist’s experiences were assessed by a questionnaire. Compression parameters were compared to previous examinations. Comparative statistics were performed using t-tests. Results Pressure-based compression (PBC) was judged to be similar or more comfortable compared with previous traditional exams (80%, 83/103), and 87% (90/103) of participants would recommend PBC to friends. Pressure variability decreased for craniocaudal (CC) views (-55%, P &lt; 0.001) and mediolateral oblique (MLO) views (-34%, P &lt; 0.0001). Subgroup analysis showed a similar glandular dose for CC views, while breast thickness was reduced (-3.74 mm, P &lt; 0.0001). For MLO views, both glandular dose (-0.13 mGy, P &lt; 0.0001) and breast thickness were reduced (-6.70 mm, P &lt; 0.0001). Mean compression parameters were similar for technologist compression and patient-assisted examinations. Conclusion Use of the pressure-based flexible paddle in DBT, with or without patient-assisted compression, improved participant and technologist experience and reduced compression pressure variability, mean breast thickness, and glandular dose.

scholarly journals Comparison of Mean Glandular Dose between Full-Field Digital Mammography and Digital Breast Tomosynthesis

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1758
Author(s):  
Kar Choon Teoh ◽  
Hanani Abdul Manan ◽  
Norhashimah Mohd Norsuddin ◽  
Iqbal Hussain Rizuana
Keyword(s):  
Digital Mammography ◽  
Digital Breast Tomosynthesis ◽  
Breast Tomosynthesis ◽  
Full Field ◽  
Mean Glandular Dose ◽  
Full Field Digital Mammography ◽  
Dose Monitoring ◽  
Significant Difference ◽  
Radiation Induced ◽  
Breast Thickness

Early detection of breast cancer is diagnosed using mammography, the gold standard in breast screening. However, its increased use also provokes radiation-induced breast malignancy. Thus, monitoring and regulating the mean glandular dose (MGD) is essential. The purpose of this study was to determine MGD for full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) in the radiology department of a single centre. We also analysed the exposure factors as a function of breast thickness. A total of 436 patients underwent both FFDM and DBT. MGD was auto calculated by the mammographic machine for each projection. Patients’ data included compressed breast thickness (CBT), peak kilovoltage (kVp), milliampere-seconds (mAs) and MGD (mGy). Result analysis showed that there is a significant difference in MGD between the two systems, namely FFDM and DBT. However, the MGD values in our centre were comparable to other centres, as well as the European guideline (<2.5 mGy) for a standard breast. Although DBT improves the clinical outcome and quality of diagnosis, the risk of radiation-induced carcinogenesis should not be neglected. Regular quality control testing on mammography equipment must be performed for dose monitoring in women following a screening mammography in the future.

scholarly journals Self-reported Pain Associated With Screening With Digital Breast Tomosynthesis

2020 ◽  
Author(s):  
Nataliia Moshina ◽  
Anders Skyrud Danielsen ◽  
Åsne Sørlien Hølen ◽  
Berit Hanestad ◽  
Elisabeth Stephansen ◽  
...  
Keyword(s):  
Pain Score ◽  
Rating Scale ◽  
Digital Breast Tomosynthesis ◽  
Ordinary Least Squares ◽  
Least Squares Regression ◽  
Compression Force ◽  
Compression Pressure ◽  
Breast Tomosynthesis ◽  
The Mean ◽  
Breast Thickness

Abstract Objective We aimed to investigate self-reported pain during screening with digital breast tomosynthesis (DBT). Methods The study was approved by the Regional Committee for Medical and Health Research Ethics in the South East of Norway (2015/424). Women completed a questionnaire about experienced pain directly after the examination, August–November 2019. A numeric rating scale (NRS, 0–10) was used. Data on compression force (N), pressure (kPa), and compressed breast thickness (mm) were obtained from the Digital Imaging and Communication in Medicine header and density assessment software. Stepwise ordinary least-squares regression was used to estimate mean self-reported pain score with 95% confidence interval (CI) for values of compression force, pressure, and compressed breast thickness. Results The mean pain score was 1.9, whereof 19.3% (822/4266) of the women reported moderate or severe pain. The mean pain score of 2.6 (95% CI: 2.4–2.7) was observed at a compression force of 60 N, decreasing to 1.3 (95% CI: 1.2–1.4) at 130 N. The mean pain score of 1.3 (95% CI: 1.1–1.4) was at a compression pressure of 6 kPa, increasing to 2.9 (95% CI: 2.7–3.1) at 16 kPa. The mean pain score was 0.6 (95% CI: 0.4–0.6) at a compressed breast thickness of 20 mm, increasing to 2.9 (95% CI: 2.7–3.1) at 90 mm. Conclusion The mean pain score was low, 1.9 on NRS, for women screened with DBT. A compression force of 60–130 N and a pressure 6–16 kPa were associated with no or mild pain.

scholarly journals Cost differences between digital tomosynthesis and standard digital mammography in a breast cancer screening programme: results from the To-Be trial in Norway

2019 ◽  
Vol 20 (8) ◽  
pp. 1261-1269 ◽  
Author(s):  
Tron Anders Moger ◽  
Jayson O. Swanson ◽  
Åsne Sørlien Holen ◽  
Berit Hanestad ◽  
Solveig Hofvind
Keyword(s):  
Digital Mammography ◽  
Controlled Trial ◽  
Digital Breast Tomosynthesis ◽  
Detailed Comparison ◽  
Term Treatment ◽  
Treatment Costs ◽  
Digital Tomosynthesis ◽  
Breast Tomosynthesis ◽  
Individual Level ◽  
Long Term Treatment

Abstract Background Several studies in Europe and the US have shown promising results favouring digital breast tomosynthesis compared to standard digital mammography (DM). However, the costs of implementing the technology in screening programmes are not yet known. Methods A randomised controlled trial comparing the results from digital breast tomosynthesis including synthetic mammograms (DBT) vs. DM was performed in Bergen during 2016 and 2017 as a part of BreastScreen Norway. The trial included 29,453 women and allowed for a detailed comparison of procedure use and screening, recall and treatment costs estimated at the individual level. Results The increased cost of equipment, examination and reading time with DBT vs. DM was €8.5 per screened woman (95% CI 8.4−8.6). Costs of DBT remained significantly higher after adding recall assessment costs, €6.2 (95% CI 4.6−7.9). Substantial reductions in either examination and reading times, price of DBT equipment or price of IT storage and connectivity did not change the conclusion. Adding treatment costs resulted in too wide confidence intervals to draw definitive conclusions (additional costs of tomosynthesis €9.8, 95% CI –56 to 74). Performing biopsy at recall, radiation therapy and chemotherapy was significantly more frequent among women screened with DBT. Conclusion The results showed lower incremental costs of DBT vs. DM, compared to what is found in previous cost analyses of DBT and DM. However, the incremental costs were still higher for DBT compared with DM after including recall costs. Further studies with long-term treatment data are needed to understand the complete costs of implementing DBT in screening.

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