Can breast compression be reduced in digital mammography and breast tomosynthesis?

OBJECTIVE. The objective of this study was to investigate the impact of decreasing breast compression during digital mammography and breast tomosynthesis (DBT) on perceived pain and image quality. MATERIALS AND METHODS. In this two-part study, two groups of women with prior mammograms were recruited. In part 1, subjects were positioned for craniocaudal (CC) and mediolateral oblique (MLO) views, and four levels of compression force were applied to evaluate changes in breast thickness, perceived pain, and relative tissue coverage. No imaging was performed. In part 2, two MLO DBT images of one breast of each patient were acquired at standard and reduced compression. Blurring artifacts and tissue coverage were judged by three breast imaging radiologists, and compression force, breast thickness, relative tissue coverage, and perceived pain were recorded. RESULTS. Only the frst reduction in force was feasible because further reduction resulted in inadequate breast immobilization. Mean force reductions of 48% and 47% for the CC and MLO views, respectively, resulted in a signifcantly reduced perceived pain level, whereas the thickness of the compressed breast increased by 0.02 cm (CC view) and 0.09 (MLO view, part 1 of the study) and 0.38 cm (MLO view, part 2 of the study), respectively, with no change in tissue coverage or increase in motion blurring. CONCLUSION. Mammography and DBT acquisitions may be possible using half of the compression force used currently, with a signifcant and substantial reduction in perceived pain with no clinically signifcant change in breast thickness and tissue coverage.