Mammography: Current practice in Australia for the selection of bucky angle in the mediolateral oblique view of the breast

Introduction: Due to the configuration of the breast and its variability between individuals, correct selection of the angle of the bucky (bucky may be interchanged with film holder; image receptor; cassette holder; detector; film holder and compression paddle; image receptor; gantry; column; C-arm) in the mediolateral oblique view of the breast is critical to maximise the amount of breast tissue demonstrated. However, there is no standardisation within the literature to instruct radiographers on how best to determine the correct angle.Most radiographers are taught to ''angle to the pectoral muscle''. The result is that there is significant variation in the techniques used to select the angle of the bucky. This study set out to investigate the current practice of bucky angle selection in Australia. Method: Surveys were distributed to both BreastScreen Australia and private practice radiographers as a way of collecting a large data sample. Responses were grouped into three categories: sample profile, clinical practice and understanding. Following collation, thematic analysis was undertaken and descriptive statistics developed.Results: One hundred and sixty eight surveys were returned. Overall the study results demonstrate that Australian radiographers were aware of the importance of correct selection of the bucky angle to maximise image quality and breast cancer detection. However significant variationsin current practice exist for the method of determination of the angle of the bucky for the mediolateral oblique view of the breast.Conclusion: Current practice for the selection of the angle of the bucky in Australia is varied and non-standardised. Variation in positioning techniques may lead to inconsistency in image quality and reproducibility and could ultimately compromise the diagnostic value of the imagesproduced. Further research into the most appropriate method for the selection of the bucky angle needs to be undertaken to inform a standardised approach to bucky angle selection, to maximise the visualisation of breast tissue and the early detection of breast cancer.