Experience of pain during mammographic screening by three different compression paddles

Abstract

Introduction - Experience of pain during screening mammography is shown to affect further attendance negatively. We aimed to explore the experience of pain during screening mammography using three different breast compression paddles.<p>

<p>Methods - Using a self-report questionnaire, we collected information on pain experienced during mammography from 938 women screened in Bodø at Nordland Hospital County in 2018, as a part of BreastScreen Norway. Pain was assessed by a numeric rating scale (NRS, 0–10). A fixed paddle, a flexible paddle or a fixed paddle standardizing pressure (study paddle) were used during screening. Compression force (kg) was recorded by the radiographers for each screening examination. Log-binomial regression was used to determine the relative risk (RR) of severe (≥7 on NRS) versus mild/moderate (<7 on NRS) experience of pain associated with type of compression paddle, adjusting for breast tenderness, shoulder(s) and/or neck pain prior to screening, compression force, age, body mass index and screening history.<p>

<p>Results - Mean score of self-reported experienced pain was 2.8 for the fixed, 2.3 for the flexible and 2.8 for the study paddle (p < 0.03 for fixed versus flexible and for flexible versus study paddle). Adjusted RR of severe pain was higher for the fixed (RRAdj 2.01, 95%CI 1.13–3.59) and the study paddle (RRAdj 2.52, 95%CI 1.44–4.42) compared to the flexible paddle. Breast tenderness was associated with a higher risk (RRAdj 1.93, 95%CI 1.04–3.58) of severe pain compared to no breast tenderness.<p>

<p>Conclusion - Women screened with the flexible paddle reported lower experience of pain than those screened with the fixed or study paddle.