Practitioner compression force variability in mammography : a preliminary study

Objective: This preliminary study determineswhether the absolute amount of breast compressionin mammography varies betweenand within practitioners.Methods: Ethics approval was granted. 488clients met the inclusion criteria. Clients wereimaged by 14 practitioners. Collated data includedBreast Imaging Reporting and DataSystem (BI-RADS) density, breast volume,compression and practitioner code.Results: A highly significant difference inmean compression used by different practitioners(p,0.0001 for each BI-RADS density)was demonstrated. Practitioners applied compressionin one of three ways using either low,intermediate or high compression force, withno significant difference in mean compressionwithin each group (p50.99, p50.70, p50.54,respectively). Six practitioners showed a significantcorrelation (p,0.05) between compressionand BI-RADS grade, with a tendencyto apply less compression with increasingBI-RADS density. When compression wasanalysed by breast volume there was a widevariation in compression for a given volume.The general trend was the application ofhigher compression to larger breast volumesby all three practitioner groups.Conclusion: This study presents an insightinto practitioner variation of compressionapplication in mammography. Three groupsof practitioners were identified: those whoused low, intermediate and high compressionacross the BI-RADS density grades. Therewas wide variation in compression for anygiven breast volume, with trends of highercompression demonstrated for increasingbreast volumes. Collation of further studieswill facilitate a new perspective on the analysisof practitioner, client and equipmentvariables in mammography imaging.Advances in knowledge: For the first time, ithas been practically demonstrated that practitionersvary in the amount of compressionapplied to breast tissue during routinemammography