Australian radiographers' approaches to mammographic imaging of women with cardiac implantable electronic devices.

Background: In the absence of Australian best practice standards, this study aimed to investigate Australian radiographers' approaches to mammographic imaging of women with cardiac implantable electronic devices (CIEDs) and to identify differences between the diagnostic and screening settings.

Methods: A survey was distributed amongst Australian radiographers with current or previous mammography experience. Questions explored whether CIED information was obtained via consent or questionnaire, the availability of CIED protocols, the views obtained, radiographer experiences, and exposure settings used. Descriptive analysis using percentages was undertaken. A chi-square test, with a significance level of p < 0.05, was used to compare differences between the screening and diagnostic settings.

Results: A sample of 220 radiographers demonstrated inconsistency and uncertainties in positioning approaches within and between radiographers and mammography settings and a knowledge gap surrounding the appropriate degree of compression for current and emerging CIEDs. Only 6 % had a consent form questioning if patients had a pacemaker or CIED; just 20 % had a site protocol to follow, with significantly higher rates in the screening compared to the diagnostic setting (p = 0.017; p < 0.001, respectively). When no protocol was available, the number of different imaging series increased from 13 to 19.

Conclusions: With no national guidelines or policies identified within Australia, radiographers appeared to lack a clear understanding of best practice imaging approaches for women with a CIED. The results of this study inform the urgent need to develop a foundation of best practice for mammographic imaging of women presenting with CIEDs. Conclusions: This study emphasises the importance of educating radiographers and creating national guidelines for safely performing mammography on women with CIEDs in Australia to address the risks posed by current knowledge gaps.