A qualitative study of mammography best practice positioning for female body habitus and breast tissue inclusion in Australia

Abstract

Introduction

Optimal positioning in mammography is key to maximise the inclusion of breast tissue on the image. This study aimed to explore the top performing Australian radiographers' mammography best positioning techniques for patients with various body habitus and their perspective on optimised breast tissue inclusion.

Methods

Twelve qualified Australian female radiographers with an age range of 20–70 years with equal representation from screening and diagnostic mammography settings were invited through Volpara® Health to participate in an online individual semi structured interview. Audio-recorded data was transcribed and analysed thematically. Key demographics of the participants include age, education, and mammographic experience.

Results

Three key themes emerged for the craniocaudal (CC) view and the mediolateral oblique (MLO) view: good communication, CC detector height and MLO image receptor (IR) angle. Responses to each theme were categorised under six female body habitus for both the CC and MLO views: small, average, large, rib hump, pectus excavatum and pectus carinatum. Effective communication was demonstrated as critical by radiographers during positioning for varied body habitus. A 45° angle was commonly used for an average, small and large body habitus.

Conclusion

Appropriate and customised positioning and effective communication is important during mammography positioning to maximise breast tissue inclusion on the image. Routine CC and MLO positioning techniques cannot be applied for patients with extreme curvature of the thorax or protruding sternum and ribs.

Implications for practice

It is critical for mammography screening programs to include a language interpretation service that targets patients from multiple cultural backgrounds to enhance effective communication during positioning. This study highlights best positioning technique by radiographers that may impact women with extreme thorax curvature or protruding ribs, and subsequent obstruction in optimal positioning.