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Author:Rauhamaa, Heini
Title:Compression in mammography: Perception of discomfort and methods for relieving pain
Puristus mammografiassa; Kipukokemus ja menetelmät kivun lievittämiseksi
Publication type:Master's thesis
Publication year:2012
Pages:x + 81 s. + liitt. 16      Language:   eng
Department/School:Elektroniikan laitos
Main subject:Sovellettu elektroniikka   (S-66)
Supervisor:Sepponen, Raimo
Instructor:Suni, Jarmo
OEVS:
Electronic archive copy is available via Aalto Thesis Database.
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Location:P1 Ark Aalto  1304   | Archive
Keywords:mammography
pain
breast compression
solutions for relieving mammography pain
mammografia
kipu
seulonta
puristus
menetelmät mammografiakivun lievittämiseksi
Abstract (eng): Mammography is an X-ray imaging application used to image breast tissue and to detect breast cancer.
During the mammography examination the patient's breasts are positioned on a mammography device's image receptor in different projections and compressed firmly with a compression paddle in order to flatten and spread out the breast tissue.
Compression is an essential part of the mammography examination and it has many benefits including that it diminishes motion blurring, enhances subject contrast by reducing scattering, and reduces X-ray dose.

For some women, though, the mammography examination can be a painful and unpleasant experience.
Studies in the mammography pain literature indicate that most women experience some degree of pain or discomfort during the mammography examination.
Currently, different solutions exist that can reduce the pain experienced during mammography such as flexible compression paddles, bi-directional compression, optimized compression, increasing the patient control over compression and using breast cushions during compression.

The purpose of this thesis was to examine the concept of mammography pain related to compression and to evaluate how different compression techniques affect the pain experience.
As a part of the thesis, a patient survey was organized at two hospital sites in Finland in order to examine how flexible compression paddle, bi-directional compression and standard compression affect the pain experience.
A total of 554 women undergoing screening mammography examination participated in the study.
Majority of the women reported that mammography was painful (82.3 - 96.2 %), but only a relatively small percentage experienced severe pain (6.6 - 20.9 %).

However, the mammography examination was the most comfortable for women who had their examination performed with the flexible compression paddle.
Also, the bi-directional compression was perceived more comfortable than the standard compression.
Overall, pain expectation, larger breast thickness under compression, younger age and standard compression were found significant risk factors for experiencing moderate or severe pain during mammography.
Abstract (fin): Mammografia on röntgenkuvantamismenetelmä, jota käytetään rintakudoksen kuvaamiseen ja rintasyövän löytämiseen.
Mammografiatutkimuksen aikana potilaan rinnat kuvataan eri projektioissa samalla kun rintaa puristetaan tiukasti kasaan puristuskaukalolla.
Puristusta käytetään, jotta rintakudos litistyisi ja levittyisi, ja se on olennainen osa mammografiaa, sillä se vähentää liikkeestä johtuvia epätarkkuuksia, parantaa kohdekontrastia vähentämällä sirontaa sekä pienentää säteilyannosta.

Joillekin naisille mammografiatutkimus voi kuitenkin olla kivulias ja epämiellyttävä kokemus.
Aikaisemmat tutkimukset osoittavat, että suurin osa naisista kokee jonkinasteista kipua mammografiatutkimuksen aikana.
Nykyään on kuitenkin olemassa useita menetelmiä, jotka voivat lievittää mammografiatutkimuksen aikana koettua kipua, kuten joustavat puristuskaukalot, kaksisuuntainen puristus (engl. bi-directional), optimoitu puristus, potilaskontrollin lisääminen sekä pehmustetyynyjen käyttäminen tutkimuksen aikana.

Tämän diplomityön tavoitteena oli tarkentaa tietämystä puristukseen liittyvästä kivusta sekä tutkia, miten erilaiset puristustekniikat vaikuttavat kipukokemukseen.
Työn osana toteutettiin potilaskysely kahdessa suomalaisessa sairaalassa, minkä avulla oli tarkoitus vertailla joustavien puristuskaukaloiden, kaksisuuntaisen puristuksen sekä tavallisen puristuksen vaikutusta kipuun.
Yhteensä 554 mammografiaseulontaan osallistunutta naista vastasi kyselyyn.

Suurin osa naisista koki mammografiatutkimuksen kivuliaaksi (82.3 - 96.2 %), mutta suhteellisen pieni osa koki kovaa kipua (6.6 - 20.9 %).
Niillä naisilla, joiden mammografiatutkimuksessa käytettiin joustavia puristuskaukaloita, mammografiatutkimus koettiin miellyttävimmäksi.
Myös kaksisuuntainen puristus koettiin miellyttävämmäksi kuin perinteinen puristus.

Kivun odotus, suuri rinnan paksuus puristuksessa, nuori ikä sekä perinteinen puristus todettiin tässä tutkimuksessa merkittäviksi riskitekijöiksi kohtalaisen tai kovan kivun toteutumiselle mammografiatutkimuksessa.
ED:2012-05-22
INSSI record number: 44607
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