Digital breast tomosynthesis in a population based mammographic screening program: Breast compression and early...

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• Digital breast tomosynthesis (DBT) is an advanced imaging technique for breast cancer screening.
• Understanding factors influencing screening performance is crucial for optimizing early detection.
• Compression force and pressure are key parameters in mammography that may affect image quality and diagnostic outcomes.

Purpose of the Study:

• To investigate the association between compression force and pressure and early performance measures in DBT screening.
• To analyze how these compression parameters relate to consensus, recall, and screen-detected breast cancer rates.
• To compare findings in DBT with those from standard digital mammography.

Main Methods:

• A retrospective analysis of 25,286 women screened with DBT was conducted.
• Data on compression force (N) and pressure (kPa), compressed breast thickness, and breast characteristics were extracted.
• Logistic regression models were used to assess associations, adjusted for relevant patient and breast factors.

Main Results:

• The highest rates of screen-detected cancer were observed with low compression force and pressure.
• No significant association was found between continuous measures of force or pressure and early performance metrics (consensus, recall, screen-detected cancer).
• Mean compression force was 90.8 N (CC) and 106.3 N (MLO); mean pressure was 11.3 kPa (CC) and 8.7 kPa (MLO).

Conclusions:

• While low force and pressure correlated with higher cancer detection, continuous force and pressure levels did not significantly impact DBT screening performance.
• These findings suggest that compression force and pressure may be less critical for screening performance in DBT compared to standard digital mammography.
• Further research may be needed to fully elucidate the role of compression parameters in DBT outcomes.