Self-compression does not affect mammogram quality in French RCT

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Takeaway

  • Self-compression mammography (vs standard compression with paddles) achieved minimal breast thickness with higher compression force without jeopardizing image quality and with less pain.

Why this matters

  • Pain from mammograms was reported as the reason for non-reattendance in 25%-46% of cases.
  • Self-compression may be an effective way for women to take an active role in their own breast examination.

Study design

  • Noninferiority randomized controlled trial (n=549) of self-compression vs standard compression.
  • Primary outcome was breast thickness by the mean of 4 views: right and left craniocaudal and right and left mediolateral oblique.
  • Predefined noninferiority margin was a difference of 3 mm, with a 1-sided 95% CI.
  • Funding: French Hospital Research Program.

Key results

  • The self-compression group (vs standard compression) had mean breast thickness within the noninferiority margin (−0.17 mm; 95% CI, −∞ to 1.89 mm; P<.006>
  • The self-compression group (vs standard compression) had higher compression force for the 4 views (all P≤.03).
  • The self-compression group had lower pain on a visual analog scale of 0-10 (median, 2 [interquartile range, 1-5] vs 3 [interquartile range, 1-5]; P=.009).
  • No differences between groups on image quality scores or in the number of additional views performed.

Limitations

  • Pain from mammography might be insufficiently high to be rated using the visual analog scale.