Current practice in mammographic imaging of the augmented breast in Australia

• Published in: Journal of medical radiation sciences Vol. 67; no. 2; pp. 102 - 110
• Main Authors: O'Keefe, Jacquelyn R, Wilkinson, Jenny Maree, Spuur, Kelly Maree
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01-06-2020; John Wiley and Sons Inc; Wiley
• Subjects: Accreditation; Adult; Australia; Breast - diagnostic imaging; Breast - surgery; breast augmentation; Breast cancer; breast imaging; Breast Implantation; Breast implants; Eklund technique; Female; Humans; Mammography; Mammography - methods; Original; Professionals; Questionnaires; Surveys and Questionnaires; Transplants & implants; Australia; breast cancer; breast augmentation; mammography; breast imaging; Eklund technique
• ISSN: 2051-3895; 2051-3909
• DOI: 10.1002/jmrs.374

Aim
This study seeks to document the imaging series used in contemporary Australian practice for imaging the augmented breast, with a secondary focus on differences in practice and opinion between BreastScreen Australia and diagnostic imaging services.
Methods
A SurveyMonkey link was distributed through the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT) and was assessable during December 2017 and January 2018. The questionnaire investigated: years of experience, facility type and location, image acquisition systems, appointment times, patients imaged per week, technique and imaging series used, use of limited compression views, rationale for variation in imaging series and the use of ultrasound. Descriptive statistics were produced for all variables with chi‐squared tests used for comparisons between categorical variables.
Results
The most frequently used series was the eight‐image Eklund ID technique 64% and 59% (submuscular) and 68% and 58% (subglandular) for BSA and diagnostic services, respectively. Eighteen different combinations of projections were reported with eight combinations common to both subglandular and submuscular imaging. The majority of participants attributed imaging series preferences to dose reduction and radiologist preference.
Conclusion
This research has demonstrated varied approaches to the routine imaging of women with breast implants and identified the need for the establishment of dedicated evidence‐based imaging protocols to ensure that regardless of which setting a woman attends that they receive standardised imaging with minimal dose and maximum breast coverage. This is a reassurance that is not applicable to current practice.
This study documents the imaging series used in contemporary Australian practice for imaging the augmented breast. Eighteen different combinations of projections were reported to be used for routine imaging with eight combinations common to both subglandular and submuscular imaging; the most frequently cited series was the eight‐image Eklund ID technique. The results demonstrate varied approaches to the routine imaging of women with breast implants identifying the need for the establishment of dedicated evidence‐based protocols for imaging of the augmented breast.