Cone Compression View Alternative Name
The cone compression view is also called the "spot compression view." 1, 2
Technical Description
The spot compression view (cone compression view) is a diagnostic mammographic technique that uses a small compression paddle—rather than the standard full-size paddle—to apply focal compression to a specific area of concern. 3
Clinical Applications
This technique serves several critical diagnostic purposes:
- Characterizes equivocal findings by dispersing overlapping breast tissue that may create false-positive densities on standard views 4
- Evaluates mass margins to determine whether borders are smooth (benign) versus irregular or spiculated (suspicious) 2
- Assesses asymmetries to determine if they persist under compression or disappear, indicating summation artifact from overlapping normal tissue 1
- Improves visualization of the subareolar region when focal asymmetry is present 1
Diagnostic Performance
The spot compression view demonstrates significant clinical utility:
- In a retrospective study of 75 equivocal lesions, spot compression made 65 lesions (87%) appear less suspicious, while 8 lesions appeared more suspicious—all 8 were confirmed cancers on biopsy 4
- Digital breast tomosynthesis (DBT) has been shown to be equivalent to or superior to spot compression views in diagnostic workup, with one study showing DBT achieved an AUC of 0.93 compared to 0.87 for standard mammography plus spot compression magnification (p=0.0014) 5
- The ACR and Italian College of Breast Radiologists note that DBT can replace traditional spot compression views in many diagnostic situations, reducing radiation exposure 3
When to Use Spot Compression
Spot compression views are indicated when:
- Initial screening mammography shows BI-RADS Category 0 (incomplete assessment requiring additional imaging) 1
- Masses or asymmetries need characterization to distinguish true lesions from summation artifact 3, 1
- Palpable findings require correlation with imaging abnormalities, using a radio-opaque marker over the clinical concern 2