Mammography is considered to be the gold standard screening modality for early diagnosis of breast cancer.
But it is associated with few drawbacks technologically, like pain due to compression, lower sensitivity for dense breast and performing breast biopsy, which makes females very anxious and avoids getting screened despite being aware of its advantages.
New technology advances and processes are looking to take the anxiety out of mammograms and encourage women to get themselves screened.
“Patient-centered care” is a popular term among those in the healthcare industry in the 21st century.
It actually means that the patient is part of their own healthcare team helping to make decisions, and they are made as comfortable as possible throughout the process.
Patient-centered mammography focuses on managing compression, streamlining or shortening the exam, and making sure the patient is fully informed about the procedure including breast density.
New technological advancements are helping in all three areas so that mammography becomes a pleasant experience for them and alleviates their anxiety.
Taking the Pain Out of Compression
Many women report that compression is the most painful or unpleasant part of the mammography exam. Sufficient compression is required, however, in order to achieve a high-quality image.
Results from various studies indicated that compression pressures in lower ranges led higher false positive rates.
Lack of consistent guidelines for mammographic compression can lead to a wide variation in execution. Both very high and very low mean compression pressure can adversely affect mammography quality. Therefore, it is reasonable to suggest that standardizing to an intermediate compression pressure may lead to better screening outcomes and a better patient experience.
Mammography vendors have started to introduce enhancements to their systems that try to make the exam less painful for patients. One common enhancement is rounding out the hard corners of the system to better mimic the shape of the breast to allow for less pinching.
GE Healthcare literally put compression in the patient’s hands with their newest mammography system, which is launched in the U.S. in early 2017. After the initial launch, GE gained U.S. Food and Drug Administration (FDA) approval for a remote device that allows patients to control their own compression. The technologist does the initial positioning and compression and then hands the remote to the patient for final adjustments.
Overall, women who used the self-compression device tended to apply more force than the technologist. It’s like the difference between you pinching yourself and someone else pinching you.
Answering Breast Density Questions
Physical comfort is just one important element of a patient-centric mammography exam. When it comes to their own healthcare, patients today want to be armed with as much information as possible to make decisions.
Over the last decade, women in particular have become more aware of the need to ask their healthcare providers about fibroglandular breast density and how it impacts screening and breast cancer risk.
The newer computer-aided detection software delivers automated, rapid and reproducible assessments of breast density to help identify patients that may experience reduced sensitivity to digital mammography due to dense breast tissue.
Making Biopsies Easier
While making the exam more comfortable goes a long way toward a patient-centric approach, any opportunity to streamline or shorten the exam should also be top of mind.
If suspicious findings are detected on a mammogram, the next step is to take a biopsy of the tissue in question and analyze whether it is cancerous. Traditionally, this has meant taking the sample — a painful process for the patient — and taking it to another room to be analyzed.
Technology has looked to streamline this process with new mammography system, which features onboard biopsy and specimen analysis tools which offers one-click targeting of suspicious areas in a mammogram, and the integrated specimen scanner completes the tissue analysis. The technologist does not have to leave the room at all during the process, leaving the patient alone to wonder and worry what the results will be.
One-Stop Breast Imaging
The ultimate goal behind all of these technological advancements — whether in compression, density assessment or streamlined biopsy procedures — is to make the mammography experience more amenable to the patient. As long as healthcare continues to move toward a more patient-centered, value-based enterprise, women’s health facilities may look to employ a combination of these and other technologies to make patient’s lives easier.
Health care providers will have to think about how to engage more women in breast cancer screening so as to make their experience as comfortable as possible and keep them actively involved during the entire procedure and also to motivate them to come forward for screening.