Patient- vs Technologist-Controlled Mammography Compression: A Prospective Comparative Study of Patient Discomfort and Breast Compression Thickness.

Objective: We assess whether mammographic patient-assisted compression (PAC) has an impact on breast compression thickness and patient discomfort compared with technologist-assisted compression (TAC).

Methods: A total of 382 female patients between ages 40 and 90 years undergoing screening mammography from February 2020 to June 2021 were recruited via informational pamphlet to participate in this IRB-approved study. Patients without prior baseline mammograms were excluded. The participating patients were randomly assigned to the PAC or TAC study group. Pre- and postmammogram surveys assessed expected pain and experienced pain, respectively, using a 100-mm visual analogue scale and the State-Trait Anxiety Inventory. Breast compression thickness values from the most recent mammogram were compared with the patient's recent prior mammogram.

Results: Between the 2 groups, there was no significant difference between the expected level of pain prior to the mammogram (P = .97). While both study groups reported a lower level of experienced pain than was expected, the difference was greater for the PAC group (P <.0001). Additionally, the PAC group reported significantly lower experienced pain during mammography compared with the TAC group (P = .014). The correlation of trait/state anxiety scores with pre- and postmammogram pain scores was weak among the groups. Lastly, the mean breast compression thickness values for standard screening mammographic views showed no significant difference in the PAC group when compared with the patient's prior mammogram.

Conclusion: Involving patients in compression reduces their pain independent of the patient's state anxiety during mammography while having no effect on breast compression thickness. Implementing PAC could improve the mammography experience.