Abtract
Purpose The aim of this paper is to determine how the presence of pain during mammographic
compression could be reduced. To this end, we examine its relationship with compression
force, surface-area of the compressed breast, breast density (ACR) and former operations.
Materials and Methods In 199 women 765 mammograms were performed. Women were asked to rate the level of
pain on a scale of 0 – 10 (0: no, 10: highest pain). The surface-area of the breast
under compression captured by the mammograms was measured using planimetry. 52 of
the 199 women were asked to identify the area of the upper body with the highest level
of pain.
Results The thickness of the compressed breast was 65.2 % of the uncompressed breast at a
force of 10 daN (57.8 % at 15 daN). When the force was increased from 10 daN to 15
daN, the average glandular dose (AGD) declined by 17 %. Tolerance of compression was
associated with the size of the breast. More than 50 % of the mammograms with a small
compression less than 9 daN were associated with higher level of pain. In the oblique
projection, 60 % of the women specified the axilla as the area of maximum pain.
Conclusion Women with larger breasts tolerated a greater force of compression. This implies
a need for individualised examination depending on the size of the breast. Women with
increased pain susceptibility terminated the compression early regardless of a small
compression less than 9 daN. More than 50 % of the women identified areas outside
breast as especially painful. Therefore, during examination, the areas around the
breast should also be taken into consideration in order to minimize unnecessary discomfort.
Key Points
With increased mammographic compression force, the effectiveness of breast thickness
reduction declined.
A compression force of 15 daN enabled an additional reduction by 17 % in average glandular
dose (AGD) compared to 10 daN.
Tolerance of increased compression force was related to breast surface area.
Women with increased susceptibility of pain terminated the compression at a low force
of less than 9 daN
Pain relating to the mammographic procedure was identified outside the breast by more
than 50 % of the women.
Citation Format
Key words breast - mammography - technical aspects - breast radiography
