Breast compression and reported pain during mammographic screening.

INTRODUCTION: We aimed to investigate the association between breast compression and experienced pain during mammographic screening. METHODS: Using a questionnaire, we collected information on pain experienced during mammography from 1155 women screened in Akershus, February-March 2018, as a part of BreastScreen Norway. The questionnaire provided information on pain using a numeric rating scale (NRS, 0-10) and related factors. Data on compression force (Newton, N), pressure (kilopascal, kPa) and breast characteristics were extracted from the DICOM-header and a breast density software. Log-binomial regression was used to determine the relative risk (RR) of severe versus mild/moderate experienced pain associated with compression parameters, adjusting for breast characteristics and related factors. RESULTS: Mean score of experienced pain was 2.2, whereas 6% of the women reported severe pain (≥7) during the examination. High body mass index (BMI) (≥27.3 kg/m2) was associated with a higher RR of pain scores ≥7 (RR 1.86, 95%CI 1.02-3.36) compared to medium BMI (23.7-27.2 kg/m2). Low compression pressure (4.0-10.2 kPa) was associated with a higher RR of severe pain (RR 2.93, 95%CI 1.39-6.20), compared with medium compression pressure (10.3-13.5 kPa) after adjusting for contact area, age, compressed breast thickness, volumetric breast density and BMI. The risk of severe versus mild/moderate pain (≥7 versus <7) decreased by 2% with increasing compression force (RR 0.98, 95%CI 0.97-1.00). CONCLUSION: Women reported low levels of pain during mammography. Further knowledge about factors affecting experienced pain is needed to personalize the examination to the individual woman. IMPLICATIONS FOR PRACTICE: Pain in shoulder(s) and/or neck prior to screening should be considered by the radiographers in a practical screening setting. A compression force of 100-140 N and pressure of 10.3-13.5 kPa are acceptable with respect to reported pain during mammography.

[Cephalometric study of the intermaxillary sagittal relationship and final clinical diagnosis]. / Estudio cefalométrico de la relación sagital intermaxilar y diagnóstico clinico final.

Due to the difficulties in finding a reliable cephalometric method to determine the true intermaxillary sagital relationship, the usefulness of the Freeman (AXB) and the Beatty (AXD) cephalometric methods are studied and, furthermore, which of them best demonstrate said sagital relationship. To perform this a comparative analysis of cephalometric methods AXB and AXD with the clinical cephalometric diagnosis were carried out using a sample of 33 individuals of both genders, between the ages 18 and 26 years, without orthodontic treatment, complete dentition and not taking into consideration third molars. The frequency distributions of class I, II and III were obtained through values given by methods AXD and AXB. The cephalometric clinical diagnosis was performed by 2 experienced observers thus obtaining absolute coincidence in their observations. The validity of methods AXD and AXB were measured in concordant percentages taking the cephalometric clinical diagnosis as the basis for comparison. Therefore, the most valid one is the cephalometric method with the highest percentage in concordance with the cephalometric clinical diagnosis. It was found that the frequency distribution of classes I, II and III are similar coincident with the one given by the cephalometric clinical diagnosis. The most valid method was the AXB bearing with the cephalometric clinical diagnosis a 90.91% concordance. The AXD method gave with the cephalometric clinical diagnosis a 75.76% concordance, which in relation with AXB, is a slightly lower percentage; however, demonstrating validity.