Compression forces used in the Norwegian Breast Cancer Screening Program

Area of Science:

• Radiology and Medical Imaging
• Breast Cancer Screening
• Health Services Research

Background:

• Mammography utilizes compression to enhance image quality and reduce radiation dose.
• The Norwegian Breast Cancer Screening Program (NBCSP) recommends a compression force range of 11-18 kg (108-177 N) for full-field digital mammography (FFDM).
• This study is the first to examine compression force application within the NBCSP.

Purpose of the Study:

• To investigate the applied compression force in the Norwegian Breast Cancer Screening Program.
• To identify variations in compression force across different breast centers, mammography machines, and radiographers.
• To assess compliance with recommended compression force ranges in FFDM.

Main Methods:

• Analysis of data from 17,951 randomly selected women undergoing FFDM screening in the NBCSP (January-March 2014).
• Examination of applied compression force on the left breast in craniocaudal and mediolateral oblique views.
• Stratification of data by breast center, mammography machine, and radiographer.

Main Results:

• The mean applied compression force was 116 N, with inter-center variation ranging from 91 N to 147 N.
• Compression force variation was greater between breast centers than between machines or radiographers within a single center.
• Only approximately 59% of mammograms adhered to the NBCSP's recommended compression force range.

Conclusions:

• Significant variability exists in applied compression force across breast centers within the NBCSP.
• The observed variations underscore the necessity for evidence-based guidelines to standardize compression force.
• Optimizing and individualizing breast compression is crucial for improving mammographic image quality and patient outcomes.