Impactos da autocompressão das mamas durante a mamografia na qualidade da imagem e na dor da paciente ao exame: uma revisão sistemática com metanálise

Abstract

Introduction: Mammography is the most used exam for breast cancer screening worldwide. One of the main factors associated with non-attendance for future mammograms is the pain felt experienced during the exam, which has been reported by many patients. Among the alternatives for reducing pain, there is breast self-compression, a technique in which the patient actively participates in the compression process, instead of this step being fully controlled by a professional. Methodology: This is a systematic review with meta-analysis carried out according to the guidelines of a systematic review by the group Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020). The databases used were Medline (Pubmed), Scopus, Web of Science, Cochrane Library, and Embase databases, using a pre-established search strategy. Data from individual studies was extracted using mean difference (MD) and standardized mean difference (SMD). Heterogeneity was evaluated with the Cochran Q test and I2 statistics. The Revised Cochrane risk-of-bias tool for randomized trials (Rob2) was applied to analyze the risk of bias. Results: In total, 6 of the 141 screened articles were eligible for quantitative analysis. Compression force in the self-compression technique was greater than standard technique (MD = 15.97; 95% CI (13.10 – 18.84); p < 0.00001]. For breast tissue thickness, self-compression technique has shown decreased values [MD = -1.87; 95% CI (-2.87 – -0.91); p = 0.0001] and glandular dosage has diminished when compared to standard technique [MD = -0.04; 95% CI (- 0.07 – -0.01); p = 0.02]. Pain levels were higher in self-compression groups [MD = 0.23; 95% CI (-0.01 – 0.47); p = 0.06]. When including only randomized studies in the subgroup analysis, we obtained similar results that showed. However, for the glandular dose it is not possible to statistically state that there is a significant difference between the groups (p = 0.11). Conclusion: self-compression is a safe technique with no inferior quality when compared with standard compression. Also, it can be a more satisfactory alternative for some patients.