Cancer Registry of Norway, P.O. 5313 Majorstuen, 0304, Oslo, Norway.
Oslo Metropolitan University, P.O. 4, St. Olavs Plass, 0130, Oslo, Norway.
Radiography (Lond). 2020 May;26(2):133-139. doi: 10.1016/j.radi.2019.10.003. Epub 2019 Nov 1.
We aimed to investigate the association between breast compression and experienced pain during mammographic screening.
Using a questionnaire, we collected information on pain experienced during mammography from 1155 women screened in Akershus, February-March 2018, as a part of BreastScreen Norway. The questionnaire provided information on pain using a numeric rating scale (NRS, 0-10) and related factors. Data on compression force (Newton, N), pressure (kilopascal, kPa) and breast characteristics were extracted from the DICOM-header and a breast density software. Log-binomial regression was used to determine the relative risk (RR) of severe versus mild/moderate experienced pain associated with compression parameters, adjusting for breast characteristics and related factors.
Mean score of experienced pain was 2.2, whereas 6% of the women reported severe pain (≥7) during the examination. High body mass index (BMI) (≥27.3 kg/m) was associated with a higher RR of pain scores ≥7 (RR 1.86, 95%CI 1.02-3.36) compared to medium BMI (23.7-27.2 kg/m). Low compression pressure (4.0-10.2 kPa) was associated with a higher RR of severe pain (RR 2.93, 95%CI 1.39-6.20), compared with medium compression pressure (10.3-13.5 kPa) after adjusting for contact area, age, compressed breast thickness, volumetric breast density and BMI. The risk of severe versus mild/moderate pain (≥7 versus <7) decreased by 2% with increasing compression force (RR 0.98, 95%CI 0.97-1.00).
Women reported low levels of pain during mammography. Further knowledge about factors affecting experienced pain is needed to personalize the examination to the individual woman.
Pain in shoulder(s) and/or neck prior to screening should be considered by the radiographers in a practical screening setting. A compression force of 100-140 N and pressure of 10.3-13.5 kPa are acceptable with respect to reported pain during mammography.
我们旨在研究乳房压迫与乳房 X 光筛查过程中疼痛体验之间的关系。
我们使用问卷收集了 2018 年 2 月至 3 月在阿克什胡斯接受乳房 X 光筛查的 1155 名女性的疼痛信息，这是挪威乳房 X 光筛查计划的一部分。问卷使用数字评分量表（NRS，0-10）和相关因素来提供疼痛信息。从 DICOM 标题和乳房密度软件中提取了压缩力（牛顿，N）、压力（千帕斯卡，kPa）和乳房特征的数据。使用对数二项式回归确定与压缩参数相关的严重与轻度/中度疼痛体验的相对风险（RR），并调整了乳房特征和相关因素。
疼痛体验的平均评分为 2.2，而 6%的女性在检查过程中报告了严重疼痛（≥7）。高身体质量指数（BMI）（≥27.3 kg/m）与疼痛评分≥7的更高 RR 相关（RR 1.86，95%CI 1.02-3.36），与中等 BMI（23.7-27.2 kg/m）相比。低压缩压力（4.0-10.2 kPa）与严重疼痛的更高 RR 相关（RR 2.93，95%CI 1.39-6.20），与中等压缩压力（10.3-13.5 kPa）相比，调整接触面积、年龄、压缩乳房厚度、体积乳房密度和 BMI 后。严重与轻度/中度疼痛（≥7 与 <7）的风险降低了 2%，与压缩力增加相关（RR 0.98，95%CI 0.97-1.00）。
女性在乳房 X 光检查过程中报告的疼痛水平较低。需要进一步了解影响疼痛体验的因素，以便根据个体女性的情况对检查进行个性化。
在实际筛查环境中，放射技师应考虑筛查前肩部和/或颈部疼痛。在考虑到乳房 X 光检查过程中的疼痛报告时，100-140 N 的压缩力和 10.3-13.5 kPa 的压力是可以接受的。
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