Analysis
Let's talk mammography
In early October, as part of my role as senior reporter for Synergy, I took a trip with SoR staff to the Aberdeen Royal Infirmary (ARI) in the Foresterhill Campus – home to the University of Aberdeen’s medical school – and Dr Gray’s Hospital in Elgin. The plan was to observe and interview radiographers working within NHS Grampian and find out more about their day-to-day life within the hospital.
A group consisting of myself, SoR head of external relations, marketing and communications Jess Reid, photographer Eva Slusarek and videographer Clark James spent two full days with radiography staff across the two hospital branches. Led by Julie Rankin – professional officer of Scotland – we were taken into the bowels of both hospitals, meeting radiographers across all modalities and units.
One of the stand-out experiences for me was visiting ARI’s mammography unit. Decked out in pink decor to mark Breast Cancer Awareness Month, the unit was quiet on the day we visited. Regardless, the mammographers we spoke to were enthusiastic about sharing their experiences working in ARI.
Why is mammography so important?
But before we get ahead of ourselves, let’s take a look at mammography itself. Mammography defines the practice of using X-ray equipment to check for or investigate abnormalities in breast tissue. In the UK, women are called for breast screening every three years between the ages of 50 and 71. Standard mammography provides an opportunity to detect breast cancer before it can metastasize. That being said, according to NHS England, around 96 in every 100 women who have a mammogram will show no sign of cancer.
Unfortunately, the UK is currently seeing a rise in mammographer vacancy rates. In its 2024 submission to the Pay Review Body, the SoR reported an increase of 17.5 per cent in the vacancy rate for mammographers in breast screening programmes within the past year. For mammographers on symptomatic programmes, the vacancy rate was even higher, at 19.5 per cent.
Meet the team at ARI
Now, let’s move on to meeting the radiographers who keep ARI’s breast screening services ticking. Alice Dewar is a consultant radiographer at ARI who is getting used to new responsibilities after recently becoming a full consultant. This makes her the first mammography consultant radiographer in NHS Grampian.
She also completed a Master’s degree in mammography in August this year – a step she had to take to become a consultant. “I think radiography is such a great profession because there are so many different routes you can go down,” she tells Synergy. “And I know I have personal reasons for going into mammography, but this and other imaging, it’s vast, really.
“It’s so diverse, and it could suit a lot of people, especially if you want to be slightly technical but still want to help in a health-related subject. I think it’s fantastic.”
Talking about her consultancy role specifically, Alice doesn’t shy away from emphasising the increased responsibility there, as well as the higher level of independence.
“A lot of things now I am doing on my own,” she explains. “It’s more responsibility. Ultrasounds, biopsies, making that decision – it’s whether there’s something suspicious, whether to speak to the lady and whether she’s got a malignancy. All that level of responsibility is more on my shoulders now that I’m a consultant.”
Meet the team at ARI
Now, let’s move on to meeting the radiographers who keep ARI’s breast screening services ticking. Alice Dewar is a consultant radiographer at ARI who is getting used to new responsibilities after recently becoming a full consultant. This makes her the first mammography consultant radiographer in NHS Grampian.
She also completed a Master’s degree in mammography in August this year – a step she had to take to become a consultant. “I think radiography is such a great profession because there are so many different routes you can go down,” she tells Synergy. “And I know I have personal reasons for going into mammography, but this and other imaging, it’s vast, really.
“It’s so diverse, and it could suit a lot of people, especially if you want to be slightly technical but still want to help in a health-related subject. I think it’s fantastic.”
Talking about her consultancy role specifically, Alice doesn’t shy away from emphasising the increased responsibility there, as well as the higher level of independence. But her team of nurses – “who are just fantastic, who I love helping me” – provide support.
“A lot of things now I am doing on my own,” she explains. “It’s more responsibility. Ultrasounds, biopsies, making that decision – it’s whether there’s something suspicious, whether to speak to the lady and whether she’s got a malignancy. All that level of responsibility is more on my shoulders now that I’m a consultant.”
Sabina Jacob
Sabina Jacob
Katrina Thompson
Katrina Thompson
A different perspective on mammography
Sabina Jacob came to the UK from India to undertake her postgraduate qualification in mammography because this qualification was not available in her home country, where there is a different attitude to breast screening. “In India, we don’t have a particular mammography position,” she says. “It’s just under diagnostic radiology. That’s why I came here.”
The UK conducts breast screening in a very different way to India, Sabina tells Synergy, which is why she decided to take the leap from diagnostic radiology to mammography. India doesn’t have a dedicated breast screening programme – if a woman comes in for a mammogram, “she would definitely have something in there”.
Katrina Thompson works in the same team as Sabina. In September, she was appointed to the role of practice education facilitator, the culmination of 10 years in mammography. “I’ve been doing a lot more training in recent years,” she says. “I’ve really, really enjoyed that.
“From there, this job came up. It was a really exciting opportunity, so I went for it. I’ve really enjoyed getting into it and seeing what’s coming up, what’s coming in the guidelines and what’s topical so that I can share this with my colleagues to help fulfil their CPD.”
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Taking on new challenges
So far, Katrina has been working to implement CPD (continuing professional development) policies into her team at ARI, making staff aware of CPD opportunities and encouraging them to get involved. The post will help mentor and support all staff in the mammography team to work towards an effective and efficient breast service, while developing and maintaining the training needs of the team.
For early-career radiographers who are thinking of going down the mammography route, Katrina urges them to go for it – especially at ARI. “It’s a really good job – we’ve got a fantastic team.
“Mammography has fantastic opportunities for advanced practice. There is the option of stereotactic biopsies, ultrasound and film reading.”
However, they should conduct their own research and be prepared to take on extra study to get to their goal, she says. “It’s really worth looking into the course and what’s involved because you’ve got to do a postgraduate certification on top of your four years of radiography. You can do it from a therapeutic or diagnostic standpoint as well, which is also a great opportunity.”
Taking on new challenges
So far, Katrina has been working to implement CPD (continuing professional development) policies into her team at ARI, making staff aware of CPD opportunities and encouraging them to get involved. The post will help mentor and support all staff in the mammography team to work towards an effective and efficient breast service, while developing and maintaining the training needs of the team.
For early-career radiographers who are thinking of going down the mammography route, Katrina urges them to go for it – especially at ARI. “It’s a really good job – we’ve got a fantastic team.
“Mammography has fantastic opportunities for advanced practice. There is the option of stereotactic biopsies, ultrasound and film reading.”
However, they should conduct their own research and be prepared to take on extra study to get to their goal, she says. “It’s really worth looking into the course and what’s involved because you’ve got to do a postgraduate certification on top of your four years of radiography. You can do it from a therapeutic or diagnostic standpoint as well, which is also a great opportunity.”
The career journey of a mammography consultant radiographer
Alice also recommends pursuing radiography, particularly if you have a love for physics like she did. That, combined with her wish to work in the healthcare profession, made radiography an easy choice. But it was also the beginning of a long road to get to her new role as a consultant radiographer. “I did a postgrad in radiography,” she tells Synergy. “Then I went into advanced practice. We do a year’s course for every advancement. There are three advanced courses that we take.
“One’s in film reading, one’s in a type of biopsy called a stereo biopsy – which is a biopsy via the mammogram route – and then one is ultrasound, so doing ultrasound imaging and core biopsies and everything that route as well. I’ve done all three of those”
Now, Alice finds that she conducts more ultrasound-based imaging than X-ray, and works primarily within the radiology group compared to the radiographer group. Breast screening, however, brings a different level of responsibility. “Screening is for 50-year-old ladies and above, and they get screened normally every three years,” she explains. “And then if we look at the mammogram and see something on it that I’m involved in, we call them back and we would do an ultrasound review, then an assessment.
“At that point, actually, we don’t have any surgeons helping us or breast care nurses to do clinical examinations. I do the clinical examination, do the full assessment, and then it’s up to me to decide whether there’s cancer there, whether they should come back or leave the clinic.”
The career journey of a mammography consultant radiographer
Alice also recommends pursuing radiography, particularly if you have a love for physics like she did. That, combined with her wish to work in the healthcare profession, made radiography an easy choice. But it was also the beginning of a long road to get to her new role as a consultant radiographer. “I did a postgrad in radiography,” she tells Synergy. “Then I went into advanced practice. We do a year’s course for every advancement. There are three advanced courses that we take.
“One’s in film reading, one’s in a type of biopsy called a stereo biopsy – which is a biopsy via the mammogram route – and then one is ultrasound, so doing ultrasound imaging and core biopsies and everything that route as well. I’ve done all three of those”
Now, Alice finds that she conducts more ultrasound-based imaging than X-ray, and works primarily within the radiology group compared to the radiographer group. Breast screening, however, brings a different level of responsibility. “Screening is for 50-year-old ladies and above, and they get screened normally every three years,” she explains. “And then if we look at the mammogram and see something on it that I’m involved in, we call them back and we would do an ultrasound review, then an assessment.
“At that point, actually, we don’t have any surgeons helping us or breast care nurses to do clinical examinations. I do the clinical examination, do the full assessment, and then it’s up to me to decide whether there’s cancer there, whether they should come back or leave the clinic.”
The importance of self examination
The breast cancer screening service at ARI has come a long since it opened in 1989. Last year, Aberdeen University made waves with an AI trial that saw a software called ‘Mia’ successfully identify interval cancers that might have been missed. Mia was created by Kheiron Medical Technologies and went on to be assessed in ARI.
After speaking to mammography professionals in the hospital, it’s clear that the future of mammography at ARI is in good hands. But how is the team cementing their good work? “It’s a teaching hospital,” Alice reminds me. “We’ve always got one or two [radiographers] with us at the same time, especially in clinic – we call it clinic E – our symptomatic clinic.”
Alice also teaches undergraduates at the university and finds this a critical opportunity to promote mammography to the radiographers of the future. “I teach the undergrad radiographers at the university every year, just for film reading, trying to raise awareness of mammography. Because I think that’s maybe one of the quieter areas in radiography that people don’t know as much about.”
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More about mammography
The SoR works closely with the National Health Service Breast Screening Programme and links to Scottish, Welsh and Northern Ireland programmes to provide professional guidance and support for the radiographic workforce including assistant practitioners.
SoR guidance and policy documents can be found here.
Image and video credit: Getty Images
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