Catherine A Doyle MS, Abstract Co-Author: Nothing to Disclose

Kate Matthews, Presenter: Nothing to Disclose

Breast compression has been shown to be a principle cause of discomfort or pain during mammography. The relationship, however, is not necessarily explicit. Interactions between anxiety and pain, as well as the influence of the radiographer, have not been widely studied. The aim of the current study was to evaluate multifactorial influences on pain during mammography.

383 women were interviewed before and after mammography in four centres. Pain, and state and trait anxiety were objectively measured using established scales. Applied compression force was documented in kg. Specific aspects of mammographic technique were documented, including: radiographic approach; level of explanation; and level of patient control of compression.

Higher compression forces (>14.5kg) caused significantly more pain (p=0.00000062). Application of machine indicated optimum compression elicited fewer pain reports (p=0.00000000) than when the radiographer subjectively determined adequate compression. Overemphasis on the potential painfulness of mammography, or on the importance of compression led to increased pain (p=0.02193608 and p=0.00000919 respectively). Allowing women verbal control of compression reduced pain (p=0.00605493). Pain was significantly associated with both state and trait anxiety. Positive actions by radiographers during the application of compression, such as using relaxation techniques and distraction, elicited fewer pain reports.

Clearly, compression force remains an important determinant of mammography pain. However, the method by which compression is applied is significant. Radiographers should note that alleviation of anxiety may make the experience less painful, and that excessively detailed explanations may increase reported pain. Patient involvement in the application of compression seems to be beneficial in alleviating pain.

Doyle, C, Matthews, K, Multifactorial Influences on Pain during Mammography.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4409552.html