Mechanical standardisation of mammographic compression using Volpara software

Elizabeth Serwan, Donna Matthews, Josephine R Davies, Minh Chau

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Introduction: Although breast compression is required in routine mammographic practices, current subjective protocols enforcing ‘breast tautness’ have minimal clinical reproducibility. While objective target force (daN) guidelines do not consider breast volumes, new pressure (kPa) measures account for associated variations. The study aims to determine characteristic compressive forces applied at an Australian diagnostic breast clinic, thereby establishing performance success in achieving ideal pressures of 10 kPa.

Methods: Parameters of 1972 mammograms were analysed retrospectively from a South Australian diagnostic breast clinic. Raw data were processed using VolparaDensity software; applied compression (force/pressure), breast thickness/volume/density and average glandular dose estimates were investigated based on breast/paddle contact areas.

Results: Distributions of applied average forces is large, yet distributions of applied average pressures are larger; this is internationally comparable. Regarding force-compressions, 98.6% are >5 daN, 16.6% are >10 daN and 0.0% are >15 daN. Regarding pressure-compressions, 94.5% are >5 kPa, 36.0% are >10 kPa and 6.3% are >15 kPa. Measures of average breast thickness/volume/density show anatomically consistent trends, with average glandular dose values constant, albeit high.

Conclusions: Applied compression forces varied significantly in relation to breast/paddle contact area; applied pressure varied to a greater extent. This is comparable with existing literature. Real-time compression pressure standardisation may benefit examination consistency. Relationships between breast volume, contact area, compression force and resultant compression pressure may aid in developing objective clinical compression protocols. Practical guidelines may increase image acquisition reproducibility, optimise patient discomfort and minimise radiation dose. Patient compliance may increase in accordance with perceived advantages of mechanical standardisation, ultimately assisting early-stage breast cancer detection.
Original languageEnglish
Pages (from-to)789-794
Number of pages6
Issue number3
Publication statusPublished - Aug 2021
Externally publishedYes


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