Clinical validation of a pressure-standardized compression mammography system

Objectives: Validation of a pressure-standardized compression mammography (PSCM) system, which aims to reduce discomfort and pain by applying the same pressure to every breast, independent of breast size.

Methods: We retrospectively studied mammograms of 39 patients acquired with a conventional force-standardized compression mammography (FSCM) technique and intra-individually compared them to mammograms acquired on a checkup visit with PSCM technique. Patients received one craniocaudal (CC) and one mediolateral oblique (MLO) compression for both breasts. All images were processed to obtain the contact area between the breast and the compression paddle. The pressure was calculated by dividing the compression force by the contact area.

Results: A total of 150 FSCM and 150 PSCM images were analyzed. The mean pressure decreased significantly from 17.1 to 12.8 kPa (p < 0.001), when using PSCM instead of FSCM. The applied pressure hardly depended on the breast contact area with the paddle (-0.014 kPa/cm²), while a clear dependency was observed using FSCM. Furthermore, the relative number of over-compressions reduced from 26% to 2%, benefitting patients with smaller breasts.

Conclusions: Our study suggests that using PSCM can reduce patient discomfort and pain during mammographic compression compared to conventional FSCM as a result of lower average pressure. Moreover, standardized pressure may provide a more constant image quality, which could improve diagnostic performance.