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European Radiology

, Volume 27, Issue 8, pp 3217–3225

First Online: 20 January 2017Received: 03 August 2016Revised: 28 November 2016Accepted: 19 December 2016


ObjectivesThis study aimed to investigate the effects of adding adjunct mechanical imaging to mammography breast screening. We hypothesized that mechanical imaging could detect increased local pressure caused by both malignant and benign breast lesions and that a pressure threshold for malignancy could be established. The impact of this on breast screening was investigated with regard to reductions in recall and biopsy rates.

Methods155 women recalled from breast screening were included in the study, which was approved by the regional ethical review board dnr 2013-620. Mechanical imaging readings were acquired of the symptomatic breast. The relative mean pressure on the suspicious area RMPA was defined and a threshold for malignancy was established.

ResultsBiopsy-proven invasive cancers had a median RMPA of 3.0 interquartile range IQR = 3.7, significantly different from biopsy-proven benign at 1.3 IQR = 1.0 and non-biopsied cases at 1.0 IQR = 1.3 P < 0.001. The lowest RMPA for invasive cancer was 1.4, with 23 biopsy-proven benign and 33 non-biopsied cases being below this limit. Had these women not been recalled, recall rates would have been reduced by 36% and biopsy rates by 32%.

ConclusionsIf implemented in a screening situation, this may substantially lower the number of false positives.

Key Points• Mechanical imaging is used as an adjunct to mammography in breast screening.

• A threshold pressure can be established for malignant breast cancer.

• Recalls and biopsies can be substantially reduced.

KeywordsMechanical imaging Mammography Breast screening Recall rates Biopsy rate AbbreviationsCCCraniocaudal

DCISDuctal carcinoma in situ

IDCInvasive ductal carcinoma

ILCInvasive lobular carcinoma

IQRInterquartile range


MIMechanical imaging

MLOMediolateral oblique

RMPARelative mean pressure over lesion area

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Autor: Magnus Dustler - Daniel Förnvik - Pontus Timberg - Ingvar Andersson - Hannie Petersson - Håkan Brorson - Anders Tingberg


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