Does elevating image receptor increase breast receptor footprint and improve pressure balance?

• Experimental study.
• 16 female volunteers/32 breasts.
• Compares two methods of conducting the cranio-caudal project.
• Provides sufficient evidence to indicate which method is likely to be superior.
• Has value to clinical mammography.

There is no consensus in the literature regarding the image receptor (IR) position for the cradio-caudal projection in mammography. Some literature indicates the IR should be positioned to the infra mammary fold (IMF); other literature suggests the IR be raised 2 cm relative to the IMF. Using 16 female volunteers (32 breasts) and a pressure sensitive mat we investigated breast footprint and pressure balance with IR at IMF and IR 2 cm above the IMF. Breast area on IR and paddle and interface pressure between IR/breast and paddle/breast were recorded. A uniformity index (UI) gave a measure of pressure balance between IR/breast and paddle/breast. IR breast footprint increases significantly by 13.81 cm2 (p < 0.02) when IR is raised by 2 cm. UI reduces from 0.4 to 0.00 (p = 0.04) when positioned at IMF +2 cm demonstrating an improved pressure balance. Practitioners should consider raising the IR by 2 cm relative to the IMF in clinical practice. Further work is suggested to investigate the effects of practitioner variability and breast asymmetry.