A Comparative Analysis of Women's Experiences with Cone Beam Breast CT and Digital Mammography in Australia

Background/Objectives: Cone-beam breast computed tomography (CBBCT) is a promising alternative to digital mammography (mammography), producing true 3D images without breast manipulation or compression. This technological difference is expected to improve patient comfort and reduce anxiety-related imaging barriers. This paper explores women's experiences comparing CBBCT and mammography in Australia. Methods: A survey at Brisbane Radiology, Queensland, Australia evaluated women's experiences of mammography and CBBCT, including perceptions of comfort, pain, positioning, anxiety, satisfaction, perceived diagnostic confidence, and future breast imaging preferences. Quantitative data were analysed using descriptive statistics; open-ended responses underwent reflexive thematic analysis. Results: Of 42 participants, the majority 30/42 (71.4%) found mammography difficult, uncomfortable 30/42 (71.4%), or dissatisfying 21/42 (50%), with 20/42 (47.6%) having previously stopped mammography due to pain (16/20) 80% or fear of compression (11/20) 55%. Conversely, women chose CBBCT primarily for its lack of compression 36/42 (85.7%) and perceived diagnostic accuracy 28/42 (66.7%). Most rated CBBCT as comfortable 33/42 (78.6%), reported high overall satisfaction 39/42 (92.9%), and preferred it for future imaging 36/42 (85.7%). Qualitative analysis identified five themes: (1) mammography-associated pain and avoidance, (2) CBBCT-associated comfort and dignity, (3) improved confidence in diagnostic accuracy, (4) the value of supportive staff, (5) accessibility concerns. Conclusions: The findings reinforce that mammography causes significant discomfort, pain, and anxiety. In contrast, CBBCT provides a positive, well-tolerated, and compression-free alternative to traditional breast imaging pathways. The small single-site sample reflects data from the only CBBCT unit in Australia, which limits the generalizability of the results. A larger sample size is needed to validate the results of this study.