OK, so imagine you have your mammogram appointment, and when you get there, the person taking the mammogram is male not female. What would you do? In the UK, that doesn’t happen, but in some countries it does. Why are we asking you to imagine it then?
The Society and College of Radiographers just held the 33rd Annual Delegates Conference – where the members of the trade union (radiographers) put forward their opinions on what they want the Society to work on the following year. This year, motion 44 made us sit up and pay attention. One of three motions brought by the Equalise group, led by @radiographerben, it asked for the Society Council to approach the NHS breast screening programme to ask whether males could become mammographers.
The motion was carried, so the council will indeed start talking to the NHSBSP about this issue.
Why is that needed?
Well, a workforce survey published by Public Health England here describes how mammographers in England are becoming scarce, with over 50% aged over 50, working part time and likely to retire in the next ten years. There’s a 15% vacancy rate too, so there’s not many of them around to start with.
Now let’s look at how thinly we spread that workforce. NHSBSP screens 2.1 million people annually, and that number is going to get 8% higher as the population increases. After you take that into account, the Age Extension trial will also make the number of women eligible for screening go up – by as much as 28%.
That’s a lot of mammograms, needing a lot of mammographers, that we don’t have enough of now, never mind in the future.
Then there’s equality. We support the notion of equality, because what’s not to like? Everyone treated the same, with the same opportunities as everyone else – no matter what creed, colour or gender. So, as there are males taking an important part in other screening programmes, why not the breast screening programme? Why are male gynaecologists and male breast surgeons and male radiologists allowed, but not male mammographers? What’s the difference here?
Why is it not needed?
The Society and College of Radiographers classed mammography as an intimate examination last year – would most of us agree with that? I think we might. So, it’s reasonable to assume that a woman having an intimate examination would prefer another woman to carry out that examination.
Another reason is that if it is an intimate examination, then you have the right to ask for a chaperone throughout. Which is a problem, as we currently don’t have enough mammographers to cover the workload, let alone spare staff to chaperone on what could become a regular basis.
Some countries do have male mammographers already, and researchers have explored why then, it doesn’t happen in other countries, notably Australia and Ireland.
In Australia a small survey asked women, most of whom had had a mammogram, to imagine if they were given a male mammographer at their appointment. 35% would be embarrassed – but 40% said they would not have a reaction. 9% would refuse the mammogram, and 11% would have the mammogram, but with a female chaperone present. No-one would refuse to see a male breast surgeon, however.
In Ireland, a much larger survey showed an identical 9% refusing to have their mammogram. 9% would have requested a female chaperone. 17.5% would not return if faced with male radiographers, and 25% said it would change their opinion of the service for the worse.
So, is it a problem?
Well, the 17.5% non-returners possibly are a problem, as the service needs to maintain a good uptake of women attending for breast screening if it is to be an effective programme – if not enough of the population attend, then we can’t diagnose enough cancers early enough to treat. We can’t afford to put people off.
However, 9% refusal – is it too high, or does it not really matter? After all, we’re trying to increase the number of mammographers for the service to continue taking mammograms at the rate that it does – needs must when faced with no choice at all?
A quick internet search brings up a few different places to look for a debate. Here’s Reddit:
I’ve seen that opinion echoed today on Twitter from @WeMammographers too.
But there’s others on Twitter who feel like this:
And that echoes what some of the research said, both in Australia and in Ireland.
Are we hypocrites for not having the same reaction to a male breast surgeon? Or do we perhaps think differently when we are a well woman, attending for screening to when we are an ill woman, attending for breast surgery? Or do we just hate change?
Is it about equality? Or is it about screening uptake? Have your say, post your comment below. Or click here to ask the WoMMeN a question.
If you want to see the tweets from the ADC as delegates discussed them, search Twitter on the hashtag #ADC2017, and give some of our fellow #radiographers a follow while you’re there!
P Fitzpatrick, A Winston and T Mooney (2008) Radiographer gender and breast-screening uptake British Journal of Cancer 98, 1759–1761. doi:10.1038/sj.bjc.6604385
H.M. Warren-Forward, B. Mackie, M. Alchin, T. Mooney, P. Fitzpatrick, Perceptions of Australian clients towards male radiographers working in breast imaging: Quantitative results from a pilot study, Radiography, Volume 23, Issue 1, February 2017, Pages 3-8, ISSN 1078-8174, http://doi.org/10.1016/j.radi.2016.05.006.