Digital breast tomosynthesis in a population based mammographic screening program: Breast compression and early performance measures

Nataliia Moshina; Marthe Larsen; Åsne S Holen; Gunvor G Waade; Hildegunn S Aase; Solveig Hofvind

doi:10.1016/j.ejrad.2021.109665

Digital breast tomosynthesis in a population based mammographic screening program: Breast compression and early performance measures

Eur J Radiol. 2021 Jun:139:109665. doi: 10.1016/j.ejrad.2021.109665. Epub 2021 Mar 19.

Authors

Nataliia Moshina¹, Marthe Larsen², Åsne S Holen³, Gunvor G Waade⁴, Hildegunn S Aase⁵, Solveig Hofvind⁶

Affiliations

¹ Cancer Registry of Norway, Oslo, Norway. Electronic address: Nataliia.Moshina@kreftregisteret.no.
² Cancer Registry of Norway, Oslo, Norway. Electronic address: marthe.larsen@kreftregisteret.no.
³ Cancer Registry of Norway, Oslo, Norway. Electronic address: asne.holen@kreftregisteret.no.
⁴ Cancer Registry of Norway, Oslo, Norway; Faculty of Health Sciences Oslo Metropolitan University, Oslo, Norway. Electronic address: gunvor.waade@kreftregisteret.no.
⁵ Department of Radiology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway. Electronic address: hildegunn.aase@helse-bergen.no.
⁶ Cancer Registry of Norway, Oslo, Norway; Faculty of Health Sciences Oslo Metropolitan University, Oslo, Norway. Electronic address: solveig.hofvind@kreftregisteret.no.

PMID: 33823373
DOI: 10.1016/j.ejrad.2021.109665

Abstract

Purpose: We aimed to determine if compression force or pressure could be associated with early performance measures for women screened with digital breast tomosynthesis (DBT) in BreastScreen Norway. Early performance measures included rates of consensus, recall, and screen-detected breast cancer.

Method: Data on compression force and pressure, compressed breast thickness and breast characteristics were extracted from an automated software for density assessment of DBT screening examinations for 25,286 women. For descriptive analyses, force (Newton, N) and pressure (kilopascal, kPa) were categorized into quartiles. Analyses were stratified by mammographic view, craniocaudal (CC) and mediolateral oblique (MLO). Logistic regression with restricted cubic splines was used to investigate the association between force and pressure as continuous exposures and early performance measures adjusted for age, compressed breast thickness and fibroglandular volume.

Results: Mean age of the screened women was 60.7 (SD = 5.2) years. Mean compression force was 90.8 (SD = 14.2) N for CC and 106.3 (SD = 20.6) N for MLO, and pressure was 11.3 (SD = 3.6) kPa for CC and 8.7 (SD = 2.0) kPa for MLO. The highest rates of screen-detected cancer were observed for low force (1.04 % for <82.5 N for CC and 1.07 % for <92.0 N for MLO) and low pressure (1.07 % for <7.2 kPa for MLO). No association was found between force or pressure as continuous exposures and early performance measures in adjusted regression analyses.

Conclusions: We found the highest rates of screen-detected cancer for low force and pressure, but no significant association between continuous values of force or pressure and early performance measures in DBT. The findings might indicate that the levels of force and pressure in DBT are of lower significance for screening performance than reported in standard digital mammography.

Keywords: Breast cancer screening; Digital breast tomosynthesis; Early performance measures.

MeSH terms

Breast / diagnostic imaging
Breast Neoplasms* / diagnostic imaging
Early Detection of Cancer
Female
Humans
Mammography*
Middle Aged
Norway / epidemiology