Health
Mammography in snapshots: Then and now

By - Integrated Care Journal

One-in-seven UK women will be diagnosed with breast cancer during their lifetime. Screening for breast cancer and catching the disease early is crucial.

Siemens first introduced equipment which could be used to image the breast in 1957 to aid in the diagnosis of breast cancer. The National Breast Screening Programme began in 1988. Although the technology behind breast cancer diagnosis and prevention has changed dramatically over time, some barriers to screening attendance still exist.

In this feature, the Mammography Team at Siemens Healthineers GB&I, take a look back through the archives and comment on how evolutions in technology have impacted mammography, how society has adapted, and how cultural barriers have influenced uptake along the way.


THEN snapshot: not the ‘done thing’

Stage in time: 1957
Technology in use: Analog mammography
Featured image: Siemens Tridoros 4 X-ray generator with mammocones

Life for women was very different in 1957 compared to today, with many choosing to prioritise their home and family life. According to research, during this time 13,398 men obtained degrees in comparison with just 3,939 women. The average age of a first-time mother was 25 in 1957, compared to 29 currently.

Mammography was in its early stages in 1957, and innovations like the Siemens Tridoros 4 X-ray generator with mammocones offered break-through technology. Breast cancer is talked about a lot more openly today than in the past, when treatment of breast cancer was more aggressive, and the number of women willing to address the issue of breast cancer risk was low. We’ve heard stories of women ignoring breast lumps, simply because talking or sharing, even with a partner, just wasn’t the done thing.


NOW snapshot: seeking a more open dialogue

Stage in time: 2018
Technology in use: MAMMOMAT Revelation with HD Tomosynthesis
Featured image: The Real Full Monty: Ladies Night (Credit: ITV)

Fast-forward to today and, although statistics show there is still work to be done (the UK lags behind the European target rate for 75 per cent screening attendance), many women in the UK are now more comfortable talking about breast cancer.

Recent TV performances, such as the Real Full Monty: Ladies Night, which was aired by ITV in March 2018 to a massive 5.5 million viewers, are helping to generate a more open dialogue. However, in some UK communities, there are still significant barriers to tackling breast cancer, with studies showing that Black and Minority Ethnic women (BME) have a particularly low uptake of the national breast screening programme, for example.

Culturally, the UK is a very different place now, but there is still work to be done to encourage some communities to engage with the issue of breast cancer. Outreach programmes are really important for both minority ethnic groups and also rural communities, where women may struggle to travel. Naturally, some women will want to bring a chaperone with them too, it is important to accommodate different requirements.


THEN snapshot: submerged in a new method

Stage in time: 1964
Technology in use: Isodense technique
Featured image: Fluidograph made by Siemens-Reiniger-Werke

By the 1960s, examination methods to diagnose and prevent breast cancer had begun to develop and by 1964 the isodense technique was introduced. The new technique involved submerging the breast in alcohol, and the Siemens Fluidograph was one of the first to use this new method.

Fluidography was an early attempt to even the breast thickness – something that is still a challenge to the present day. Comfort (or rather a concern about discomfort) is one of the key reasons why some women do not attend a screening and so we are still constantly striving to improve this situation.


NOW snapshot: reinventing the experience

Stage in time: 2018
Technology in use and featured image: MAMMOMAT Revelation with HD Tomosynthesis

For a long time, mammography has not been considered a pleasant experience for some women – and looking at some of the old images it is easy to see why.

Technology has evolved dramatically over the years and continues to do so, meaning that the process has now completely changed. The experience varies for everyone and while a mammogram will perhaps never be completely comfortable, the latest innovations are quicker, more accurate, and are designed with the patient in mind.

The MAMMOMAT Revelation with HD Tomosynthesis has the very latest technology in breast imaging and has been designed to make mammography a less daunting experience for patients. The system has features such as soft compression paddles and is able to complete a highly accurate image within a few minutes, meaning a mammogram can be performed quicker than ever before.


THEN snapshot: screening at a lower dose

Stage in time: 1988
Technology in use: Analogue mammography with reduced radiation
Featured image: MAMMOMAT 2 

From the 1980s onwards, mammography started to become more patient-centric. There was an emphasis on making the process quicker for the patient, and new developments also started to acquire the images using a lower dose of radiation, meaning a reduction in risk to patients.

Innovation had started to accelerate, and the equipment began to look more familiar to the systems used today. With the patient in mind, lower dose levels made mammography a safer form of examination, the design and features of the machines had also started to incorporate ways of making the overall experience more agreeable.


NOW snapshot: so much to do and so little time

Stage in time: 2020
Technology in use: MAMMOMAT Revelation with 50° Wide-Angle Tomosynthesis
Featured image: InHealth visit the Mobile Digital Mammography Unit during its tour of the UK and Ireland

Women today lead busy and demanding lives. In 2017 more women achieved university places than men, and in 2016, an estimated 163 million women were starting or running new businesses in 74 economies around the world. For those working in London, they spend an average of 72.8 minutes a day just to get to work.

With so much to do in so little time, it’s important that healthcare slots into women’s busy schedules without too much inconvenience caused. Getting women to attend screening is the key; from there we can provide the latest technology to catch cancer early.

Being aware of the pressures women in today’s society are under is vital and finding new ways to engage with a wider group of women remains important. Installing mobile units in helpful locations like supermarket car parks is just one way of ensuring that screening is made as accessible as possible.


The constant challenge in the evolution of mammography technology is adapting to change 

As we have seen, women’s expectations and lifestyles have altered a lot since the 1950s, and they have also changed significantly since breast cancer screening was first introduced 30 years ago.

Screening currently diagnoses about 10,000 cases of breast cancer annually, and since 1988 has saved many lives by early detection of breast cancer.

Crucial to its success is continued innovation. No matter what cultural background women may have, or where in the country they may live, mammography within the NHS strives to accommodate differences in lifestyle requirements and perspectives. Advancing technology is the tool that has provided us with the ability to expand precision medicine, transform care delivery and improve the patient experience.

Click here for more information on the MAMMOMAT Revelation with 50° Wide-Angle Tomosynthesis

If you would like to visit our Mobile Digital Mammography Unit please contact joanne.barry@siemens-healthineers.com


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