Mammography with breast cushions

Dibble, Suzanne L.; Israel, Jill; Nussey, Brenda; Sayre, James W.; Brenner, R. James; Sickles, Edward A.

doi:10.1016/j.whi.2004.12.001

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Volume 15, Issue 2 , Pages 55-63, March 2005

Mammography with breast cushions

Suzanne L. Dibble, RN, DNSc
- Institute for Health and Aging, University of California, San Francisco, California
- Address correspondence to Suzanne L. Dibble, RN, DNSc, Institute for Health and Aging, University of California, San Francisco, 3333 California St. Suite 340, San Francisco, CA 94118.
Jill Israel, BSN, RN
- Institute for Health and Aging, University of California, San Francisco, California
Brenda Nussey, BA
- Institute for Health and Aging, University of California, San Francisco, California
James W. Sayre, PhD
- Department of Biostatistics, School of Public Health, University of California, Los Angeles, California
R. James Brenner, MD, JD
- Eisenberg Keefer Breast Center, John Wayne Cancer Institute, Tower- St. Johns Imaging, St. Johns Health Center, Santa Monica, California
- Department of Radiology, Geffen School of Medicine, University of California, Los Angeles, California
Edward A. Sickles, MD
- Department of Radiology, School of Medicine, University of California, San Francisco, California

Received 12 July 2004; received in revised form 11 November 2004; accepted 21 December 2004.

Objective

We conducted a randomized clinical trial to determine the impact on pain and image quality when breast cushions were used to pad the surfaces of the mammography equipment during film-screen mammography.

Methods

We recruited a consecutive volunteer sample of 394 participants. Breast cushions were used for only one breast, with laterality and sequence of use assigned randomly. Data collected from participants included demographic data, rating of pain from previous mammography, and rating of pain from present mammography using both a numeric rating scale and a visual analogue scale. Research assistants also collected breast compression and radiation exposure data. Radiologists were blinded to the laterality of cushion assignment while reading the mammograms and assessing image quality.

Results

Participants were primarily white women (75.3%), mean age 55.4 years. Most (94.4%) reported having previous mammography. Eight percent (n = 32) of those surveyed had thought about skipping or delaying mammography because of the pain involved. The pain associated with mammography was significantly (p < .001) less during oblique and craniocaudal views when breast cushions were used during the procedure. Retakes were required for 2% of the 1576 views with the most common reason being positioning (53%).

Conclusion

The use of breast cushions significantly reduced the pain during film-screen mammography. Image quality with the cushions was reduced in a very small subset of women probably due to the difficulty in positioning the breast without visual clues. More research needs to be done prior to the routine use of these cushions in clinical practice.