Compression in mammography and the perception of discomfort.

Breast compression in mammography is an uncomfortable experience for most women. The discomfort experienced has the potential to deter women from attending regular breast screening by mammography. The aim of the present study was to assess factors related to the degree of discomfort experienced by women attending for first-time mammography at the Central and Eastern Sydney BreastScreen Service. Prior to the mammogram, expectations of discomfort, menstrual status, existing breast pain, and other breast problems were recorded on a questionnaire. At the time of the mammogram, breast size and weight were estimated. During the mammogram one of the craniocaudal views of the breast was taken at a slightly lower level of compression and after the procedure the participants were asked if they perceived any difference in discomfort between the normally compressed view and the less compressed view. Radiologists were asked to comment on any differences in image quality between the same two cranio-caudal films. A total of 200 women, including non-English-speaking women, participated in the present study. A total of 29% of women reported moderate, considerable or severe discomfort, a much higher level than reported in previous studies. The source of expectations (P = 0.001) had a significant relationship to the expectation of discomfort. Prior expectations (P = 0.01) and breast weight (P = 0.001) were the only factors found to have a significant relationship to the experience of discomfort. The analysis of differences in level of compression and discomfort indicates that the relationship between mammography discomfort and level of compression is complex and not simply the result of the amount of compression applied. However, analysis of the relationship of varying compression and image quality suggests that a slight lowering in the level of compression is unlikely to significantly compromise perceived image quality. Directions for further research are suggested.