Introduction: Mammography is a diagnostic method that allows visualisation of the breast’s soft tissue and pathological changes. Artefacts can be observed in mammographic images and detection of these artefacts is crucial for optimising image quality. Cardiovascular implantable electronic devices are among the artefacts that not only affect image quality but can also mask breast abnormalities and impact the execution of mammography. Purpose: The purpose of this study was to determine how the presence of cardiovascular implantable electronic devices, such as pacemakers, implantable cardioverter defibrillators and implantable loop recorders, affects the execution and quality of mammographic images. Methods: We used a descriptive method with a systematic literature review. We included scientific articles in English that were freely available in full text and published between 1999 and 2024. The following keywords were used: mammography and cardiovascular implantable electronic devices, mammography and pacemaker, mammography and cardioverter defibrillator, mammography and loop recorder. Results: Fourteen articles suitable for analysis were included in the systematic review. The studies were conducted in different countries worldwide and included case studies, retrospective studies, original research articles and literature review as research designs. The studies analysed the location of different cardiovascular devices, their impact on diagnostic utility and image quality. In addition, they reported on breast compression and thickness, pain and anxiety during mammography, radiographer experience and damage to the device. Discussion and conclusion: We found that the presence of cardiovascular implantable electronic devices affects the execution and quality of mammograms. Images often fail to meet even the basic quality assessment criteria. The frequency of occurrence of these devices in mammography is quite low. Compression on the side of the implanted device is often lower than recommended. In addition, cardiovascular implantable electronic devices can obscure critical areas and thus interfere with mammography in patients at high risk of developing or being diagnosed with breast cancer. For patients, the presence of the device causes more pain, anxiety and discomfort during mammographic imaging. Radiographers perceive imaging women with an implanted device differently and are often more cautious. There is also a possibility that mammography could damage these devices.
|
