GE approached this problem in two ways, by making the paddles that compress the breast more flexible, and by putting compression control in the hands of the patient.
Says O’Connor: “When you have really rigid paddles and you compress the breast, you’re squishing it in a vice, and what hurts is not the compression itself but the shearing as parts of your breast move to the left and parts of your breast move to the right.
As 2017 Breast Cancer Awareness month draws to a close, Sunshine Coast radiologist, Dr Sean O’Connor has one message for women: “Let us find breast cancer before you do — when it’s small and treatable.” He identifies two aspects of mammography as critical to accurate, early — before you may even feel a lump — detection of breast cancers: medical-image quality and adherence of women between the ages of 40 and 74 to bi-annual screening.
In February this year, O’Connor’s Coastal Medical Imaging and László Tabár Breast Centre became the first Australian site, and the third medical-imaging clinic in the world, to instal imaging technology that significantly improves the outcomes of both clarity of breast images, and the level of comfort and care that women experience during screening.
Among the differences between previous 3D tomography technology and the Senographe Pristina, says O’Connor, “is that this is a purpose-built machine — it hasn’t had 3D cobbled onto it”.
Importantly, he says that the acquisition of submillimetre image slices of the breast, and subsequent submillimetre accuracy in reconstruction of the 3D view using GE’s ASi R iterative reconstruction algorithm, result in much clearer visualisation of breast abnormalities than was previously possible, with superior reduction of distracting artefacts.
With a growing number of studies in Europe and the US showing 3D mammography detects more cancers than 2D, and that it also reduces the incidence of false cancer diagnoses, Breast Screen Victoria is now trialling 3D tomosynthesis, for effectiveness and feasibility in the broad Australian context.
In tomosynthesis the x-ray tube moves in an arc over the compressed breast to capture multiple images from different angles.
O’Connor identifies Pristina’s soft-plastic face shield as a particularly inspired design element, the use of which is intuitive to patients and helpful to technologists: “You lean your face into it, and its positioning means you and the technician don’t have to worry about your face blocking the image acquisition.” “We wanted to build a machine that changed the subjective perception of the mammogram and spoke to the woman, to make her feel reassured,” says industrial designer Aurelie Boudier, one of the women on the team that developed Pristina.
Insights from more than 1,200 doctors, technicians and patients surveyed by GE suggested that willingness to return for regular mammograms is affected by women’s initial experience of compression of their breasts to achieve what’s known as a minimum diagnostic thickness.