Don’t tell me to hug a machine. Why we must fix the mammogram experience

Let’ts set the scene. Pink ribbons are everywhere, and the cultural dialogue — for the first time in 11 months — returns to breast cancer. Why?

Well it’s Breast Cancer Awareness Month, of course. An annual reminder for al to “think about the girls” — with calls to action echoing to “get out there and get screened.” And by screened, they mean mammograms... that singular experience dreaded by women the world over. And yet, we know for a fact — thanks to the American Cancer Society — that mammograms are the best way to detect cancer at early stages, when less aggressive treatment methods and a cure are more likely. And we also know for a fact that a woman’s risk increases with age.

But while the research is compelling, there’s a slight downward trend in the number of women over 40 who are getting regular mammograms — just 65.6% in 2018. In other words, just two-thirds of women who should be getting screened, are getting screened.

Not good enough. Not nearly good enough.

We should be asking ourselves why that’s the case, before asking how we’re planning to address the issue.

The answer to the former is three-fold. For one, guidelines about when to start screening have shifted, with baseline mammograms now suggested for women once they reach 35. Secondly, many lack clarity around their risk level — basing their perceived risk around whether other women in their family have had it. But consider this: 87% of women with breast cancer have no direct family history of the disease. Additional barriers include not having healthcare coverage or an established connection with a provider, lack of paid time off of work, a need for childcare, or not having social support that could help if cancer is detected.

But the third is simply the fact that many women dread the anticipated pain of the screening or have general scan-related anxiety known as scanxiety. Because — let’s get real — the experience can range from discomfort at best, to downright painful.

And the logistics...whew. A few years ago, I was instructed by a kind, compassionate technician, to try to “hug” the machine. It was like being asked to hug an industrial refrigerator, but worse. And then, there was the precarious dance to get into the right position before the “hold right there” and the impending “don’t move!” and “don’t breathe!”

The experience — though unpleasant — don’t last forever, and we know it’s our best option when it comes to early detection. But couldn’t it all be so much better? Couldn’t we design something that encourages women to get screened; something which convinces the remaining third of women to book their mammogram ASAP?

First, let’s think holistically about the experience

Healthcare facilities — both mobile and office-based — naturally want women to have a positive experience and return. Of course they do. But functional constraints and the overall inertia of “how it’s always been done’ often calls the shots.

It doesn’t have to be that way. We can design an experience that provides as much comfort as possible — and we can do that by thinking “beyond” the hospital setting.

Some facilities have taken steps in recent years to purposefully improve their environments with thoughtful decisions around color and music, while others have chosen to create a living-room-esque environment with gas fireplaces. Some now provide a heated “tie-in-the-back” gown and others offer a pair of slipper socks.

But better, yet, why not actually create a spa-inspired experience — complete with a spa robe and real slippers? Why not infuse a dose of luxury into a setting which has never known it previously? It finally feels like we’re on the right track, but we certainly can’t stop there.

GE Healthcare created the CT Pirate Island Adventure, a CT scan that helps to distract and engage children during the experience. While I don’t think any woman wants to get on the SS Mammogram, the same logic could apply with a machine designed to reduce anxiety and invite a mental escape. And let’s face it: We not only have the smarts and the tech, we have the inspiration and the know-how. We can actually do this.

Perhaps a function of my age, but my social media feed often includes messages by friends posting an after-mammogram “Get your checks ladies!” reminder. Grassroots social encouragement is wonderful, but there could be a more codified after-scan experience. What is the mammogram equivalent to the beloved I Voted sticker? Obviously the context is different — literally life and death — but there’s definitely something there and it’s a ripe opportunity for a brand to innovate on a social scale. Heck, I’d totally wear a sticker and proudly sport it on my Zoom calls.

Next, why not create a kinder, more inclusive mammogram?

While mammogram machines are designed to move up and down, they are not actually inclusive of different body types. And I’ll state the obvious here: Women come in all shapes and sizes.

Some women must crouch, and others have to get on their tip-toes. Women with physical or mental disabilities face additional barriers when it comes to accessing (dare I call it “hugging”) the machine, which more than likely adds further anxiety. The stakes are necessarily high because the quality of the scan is critical, and higher-quality scans reduce unnecessary callbacks. You get the gist.

Heavier women may require more frequent screenings in order to effectively detect early stage tumors. An important note given that heavier people — and particularly women — are increasingly marginalized in healthcare settings. Technology that reflects diversity in size and ability would create more equity in screening, perhaps with flex capabilities.

And it we’re being asked to hug a machine, why can’t we “ask” the machine to hug us back?! Factoring in better ergonomics with more intuitive curves and indentations would create a more natural feeling screening process. Good design means not having to ask, “Where does my hand go?”

Some companies, including Hologic, have made strides to improve the experience by creating curved plates called SmartCurve (which Fast Company wrote about in 2017). Unfortunately, these are not yet standard practice — meaning the room to innovate remains.

And on that note, innovation must extend beyond the physical experience.

When you go for a massage or spa treatment, some intake forms allow you to select the amount of social interaction you want to have during the experience. Some people find talking relaxing, others don’t. How could screening centers adopt a similar approach? Some dialogue is necessary, of course, but planning ahead to support different coping experiences could help women to feel better understood and better supported.

For many, the feeling of dread quickly turns to relief after the experience is over. But even a false-positive experience can create screening-related anxiety that lasts up to three years. Referrals to social workers or care coordinators — even for those who do not get a negative result — could further normalize the common experience of scanxiety and help bridge the social support gap for those in need.

Time is of the essence...literally. Approximately 1 in 8 women will develop breast cancer in their lifetime, and almost every family will be touched somehow by breast cancer. Treatments are continuing to improve — and it all starts with effective screening. So instead of simply throwing a pink ribbon on your logo this year, why not invest in the tech and solutions which save lives? Why not endeavour to really show up for women?

My call-to-action is this: Consider how your brand can play a role in systematically improving the mammogram experience. That could be through upstream tech innovation that makes the experience more comfortable or by retooling the social support structure, or even by contributing to thoughtful enhancements that reflect a person-centered approach. Opportunity for better exists in abundance — and we can design it.

First published in Fast Company.