New technology advances and processes are looking to take the anxiety out of mammograms and encourage women to get screened. “Patient-centered care” is a popular term among those in the healthcare industry in the 21st century.

It means the patient is part of their healthcare team helping to make decisions, and they are made as comfortable as possible throughout the process. Vendors are starting to adopt this approach for mammography, arguably the most critical tool for detecting breast cancer.

Patient-centered mammography focuses on managing compression, streamlining or shortening the exam, and making sure the patient is fully informed about the procedure including breast density. New technological advancements are helping in all three areas.  

Taking the Pain Out of Compression

Many women report that compression is the most painful or unpleasant part of the mammography exam. Sufficient compression is required, however, to achieve a high-quality image.

A Dutch study published in late 2017 examined this relationship by looking at more than 130,000 mammograms taken from the Dutch Breast Screening Program and Volpara software.

The data used was subdivided into five equal parts of mean pressure, adjusted for volumetric fibroglandular breast density and breast volume. Results indicated that compression pressures in lower ranges led to higher recall rates and, more importantly, higher false positive rates.

“Lack of consistent guidelines for mammographic compression can lead to a wide variation in execution. The study shows that adequate compression pressure is crucial for obtaining high-quality exams,” said Nico Karssemeijer, Ph.D., of Radboud University Medical Centre in Nijmegen, Netherlands.

"Both very high and very low mean compression pressure can adversely affect mammography quality. Therefore, it is reasonable to suggest that standardizing to an intermediate compression pressure may lead to better screening outcomes and better patient experience,” said Karssemeijer.

Mammography vendors have started to introduce enhancements to their systems that try to make the exam less painful for patients. One common enhancement is rounding out the hard corners of the system to better mimic the shape of the breast to allow for less pinching.

Hologic introduced the SmartCurve breast stabilization system on the 3-Dimensions system. This curved stabilization plate allows a better distribution of force across the entire breast. Research shows the plate improved patient comfort in 93% of women who reported moderate to severe discomfort during compression.

An image processing algorithm inside the SmartCurve ensures there are no changes in positioning or workflow for the technologists and radiologists administering the exam. GE Healthcare put compression in the patient’s hands with their newest mammography system, Senographe Pristina, which launched in the U.S. in early 2017.

After the initial launch, GE gained U.S. Food and Drug Administration (FDA) approval for a remote device called Dueta that allows patients to control their compression. The technologist does the initial positioning and compression and then hands the remote to the patient for final adjustments.