Towards a biomechanical breast model to simulate and investigate breast compression and its effects in mammography...

Objective. In mammography, breast compression forms an essential part of the examination and is achieved by lowering a compression paddle on the breast. Compression force is mainly used as parameter to estimate the degree of compression. As the force does not consider variations of breast size or tissue composition, over- and undercompression are a frequent result. This causes a highly varying perception of discomfort or even pain in the case of overcompression during the procedure. To develop a holistic, patient specific workflow, as a first step, breast compression needs to be thoroughly understood. The aim is to develop a biomechanical finite element breast model that accurately replicates breast compression in mammography and tomosynthesis and allows in-depth investigation. The current work focuses thereby, as a first step, to replicate especially the correct breast thickness under compression.Approach. A dedicated method for acquiring ground truth data of uncompressed and compressed breasts within magnetic resonance (MR) imaging is introduced and transferred to the compression within x-ray mammography. Additionally, we created a simulation framework where individual breast models were generated based on MR images.Main results. By fitting the finite element model to the results of the ground truth images, a universal set of material parameters for fat and fibroglandular tissue could be determined. Overall, the breast models showed high agreement in compression thickness with a deviation of less than ten percent from the ground truth.Significance. The introduced breast models show a huge potential for a better understanding of the breast compression process.