Compression force variability in mammography in Ghana – A baseline study

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Radiography (Lond). 2020 Jul 30:S1078-8174(20)30131-0. doi: 10.1016/j.radi.2020.07.007. Online ahead of print.


INTRODUCTION: Breast compression during mammographic examinations improves image quality and patient management. Several studies have been conducted to assess compression force variability among practitioners in order to establish compression guidelines. However, no such study has been conducted in Ghana. This study aims to investigate the compression force variability in mammography in Ghana.

METHODS: This retrospective study used data gathered from 1071 screening and diagnostic mammography patients from January, 2018-December, 2019. Data were gathered by seven radiographers at three centers. Compression force, breast thickness and practitioners’ years of work experience were recorded. Compression force variability among practitioners and the correlation between compression force and breast thickness were investigated.

RESULTS: Mean compression force values recorded for craniocaudal (CC) (17.2 daN) and mediolateral oblique (MLO) (18.2 daN), were within the recommended values used by western countries. Most of the mammograms performed – 80% – were within the National Health Service Breast Screening Programme (NHSBSP) range. However, 65% were above the Norwegian Breast Cancer Screening Programme (NBCSP) range. Compression forces varied significantly (p = 0.0001) among practitioners. Compression forces increased significantly (p = 0.0001) with the years of work experience. A weak negative correlation (r = -0.144) and a weak positive correlation (r = 0.142) were established between compression force and breast thickness for CC and MLO projections respectively.

CONCLUSION: This initial study confirmed that although wide variations in compression force exist among practitioners in Ghana, most practitioners used compression forces broadly within the range set by the NHSBSP. As no national guidelines for compression force currently exist in Ghana, provision of these may help to reduce the range of variations recorded.

IMPLICATIONS FOR PRACTICE: Confirmation of variations in compression will guide future practice to minimize image quality disparities and improve quality of care.

PMID:32741566 | DOI:10.1016/j.radi.2020.07.007