Mammographic compression: A need for mechanical standardisation

This chapter introduces the problem of lack of standardisation of compression-variability of compression force exists between and within practitioners. This variability could have an impact on image quality, radiation dose, the persons experience and consequently re-attendance rates. The approach to compression force application has not changed greatly over the last few decades, so little progress has been made to resolve the issue. A new approach, based upon pressure, has recently appeared in the literature; consequently, we invited the authors of this chapter to outline it. In outlining the pressure based approach they use new data to compare clinical practice of mammographic compression in two countries: the Netherlands, where a minimum force of 12 decanewton (daN) is maintained, and in the United States (U.S.), where no target force is specified. Within this chapter two large data sets (Netherlands: n = 13,610; U.S.: n = 7179) of mammography DICOM files were retrospectively analysed using dedicated software (VolparaAnalytics and VolparaDensity, Volpara Health Technologies Ltd., Wellington, New Zealand). Data is analysed as function of breast size (contact area) in order to examine in what way practitioners adjust the compression to individual breast size. Given that new data is used to outline the pressure based approach, this chapter follows a similar format to a journal article.