Impact of breast density on the compression mammography and mean dose of glandular exposure during a digital mammography in patients undergoing a breast cancer screening program
DOI:
https://doi.org/10.53903/01212095.310Keywords:
Mammography, Breast density, Breast compression, Radiation dosageAbstract
Objective: To evaluate the impact of breast density on the compression and dose of exposure of patients admitted to the breast cancer screening program with direct digital mammography. Material and Methods: Analytical observational study in patients who entered breast cancer
screening, between August and December 2019. All of them underwent standard mammographic views: craniocaudal (CC) and mediolateral oblique (MLO), with a Direct Digital Mammography equipment (Senographe Essential, GE). Patients with previous surgeries were excluded. The
thickness at the end of compression (mm), compression force (daN) and mean glandular dose (MGD) in mGy, were considered. The technique and interpretation (BI-RADS) were carried out by two technologists and two radiologists with more than 10 years of experience in breast image respectively. They were grouped into dense (C and D) and non-dense (A and B). The Mann-Whitney test was used to differentiate between means. For continuous quantitative, the correlation coefficient was used. A p<0.05 was considered significant. Results: A total of 478 breasts (239 patients) were evaluated. The average age was 56.8±8.4. When comparing the mammographic density with the thickness at the end of compression, this was significantly lower in dense breasts (C and D), compared with non-dense
(A and B): 58.4±9.1 vs 61.3±10.1mm; and 65.1±10.6 mm vs 68.1±11.4mm in CC and MLO views respectively (p<0.001, p=0.002). The compression force was significantly lower in dense breasts (7.9±1.0 daN), compared to non-dense (8.8±2.1daN), only in CC views (p <0.001). When evaluating the MGD, there was a significant direct correlation between thickness at the end of the compression and MGD (r2=0.21,p<0.001). In all projections, there were no significant differences between doses and breast
density (p=0.8). Conclusion: It is important to obtain a minimum thickness at the end of compression for a good image, especially in dense breast. However, it is not necessary to apply compression forces higher than the standard or exceed the degree of tolerance. Also there are no significant increased doses of glandular exposure in dense breasts with digital mammographic technique.
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