KEY TAKEAWAYS
- The study aimed to investigate the effects of curved versus standard paddles on pain and image quality in BC screening.
- Researchers noticed that while the curved paddle slightly reduced pain, it also led to a reduction in image quality.
Breast cancer (BC) screening can be a painful experience for many women, and a curve-shaped compression paddle has been proposed as a potential solution to alleviate discomfort. However, concerns arise regarding whether this new system might affect the contrast and visibility of structures in the mammographic images, which are crucial for accurate diagnosis.
Daniëlle van der Waal and the team aimed to compare the efficacy of curved versus standard compression systems in terms of pain experience and image quality during mammography screening.
They performed an inclusive analysis in this randomized controlled trial conducted between October 2021 and February 2022. Patients screened at 3 screening sites in the Netherlands were randomized to either a curved-paddle or sham-paddle group. The sham paddle was a standard paddle presented as a new design.
During a standard screening examination, 1 additional image was acquired with either the curved or sham paddle. The pain was measured using a numerical rating scale (range, 0-10), with participants providing pain scores after compression with both the standard and test paddles, resulting in 2 scores per participant. Differences in pain scores were compared between groups using analysis of covariance, adjusting for pain score after standard-paddle compression.
The 2 radiographers and 2 radiologists performed unblinded paired comparisons of images taken with the curved vs standard paddles, using standard image quality criteria. Radiographers evaluated 1,246 image pairs with 12 criteria, while radiologists evaluated 320 image pairs with 6 criteria. The 1-sample Wilcoxon signed-rank test was used to determine if there was a significant preference for either paddle.
About 2,499 female participants (mean age, 61.6 years ± 7.1 [SD]) were studied, with 1,250 in the curved-paddle group and 1,249 in the sham-paddle group. The mean pain score decreased by an additional 0.19 points in the curved-paddle group compared with the sham-paddle group (95% CI: 0.09, 0.28; P < .001).
In terms of image quality, observers showed no preference or preference for the standard paddle. Decreased image contrast (range Bonferroni-corrected P values: P < .001 to P > .99) and visibility of structures were the main concerns for curved-paddle images.
The study concluded that while the use of the curved paddle resulted in a minimal reduction in pain during mammography breast compression, it also led to a decrease in image quality.
No funding information was given for this study.
Source: https://pubmed.ncbi.nlm.nih.gov/39162635/
van der Waal D, van Landsveld-Verhoeven C, Tetteroo E, et al. (2024). “Pain Experience and Image Quality with Curved versus Standard Compression for Breast Cancer Screening Mammography: A Randomized Controlled Trial.” Radiology. 2024 Aug;312(2):e232680. doi: 10.1148/radiol.232680. PMID: 39162635.
