the context of a significant and constant increase in exposure to
ionizing radiation (IR) in medical imaging, an ever-increasing number of
studies on radiation-induced risks in medical imaging are being
published (Mathews, 2013 ; Colin et al, 2017). However, health
professionals in the field have different opinions about this issue
(IRSN, 2012). While the risks of radiation-induced cancers associated
with low doses of IR - especially in women under 50 who perform
screening mammograms - may be considered a necessary evil by some
radiologists, others are less of this opinion. Although the French
National Cancer Institute (INCa 2014b) have provided recommendations to
address this issue, healthcare practices do not seem to have changed
This PhD thesis in social psychology of health
aimed to investigate public health issues related to exposure to IR in
screening mammograms by integrating the interactions between
individuals, the social and cultural context, and the object studied
(Apostolidis, Dany, 2012). The research work focused on understanding
what guides radiologists’ and women’s decisionmaking processes in terms
of performing breast-cancer screening or not, in the French context.
Social representations theory (Moscovici, 1961) was used, as it
constitutes a suitable theoretical basis to investigate the sociogenesis
of knowledge when confronted with an unknown and abstract object, or
radiation-induced risks in the present context (Apostolidis, Duveen,
Kalampalikis, 2002, Jodelet, 1989).
practical field issues with theoretical perspectives, we aimed to
investigate the social representations of mammograms, particularly
regarding the IR dimension, and the perception of the risks associated
with them, especially in women under 50 years of age.
To study this question, four studies were conducted:
study of a corpus of 236 institutional documents, to gain a better
understanding of both the national context, and public health
institutions’ points of view about breast cancer screening in France.
study of a corpus of 430 articles from the mainstream press, to
identify common language elements regarding screening mammograms.
- A study of 1,300 women, representative of the French population, to investigate their representations of screening mammograms.
- A study of 292 radiologists, to explore their representations and perceptions of the risks associated with screening mammograms.
results helped highlight the social health norms linked to the decision
to have a screening mammogram in women under 50 years of age in France.
The majority of radiologists surveyed seemed to agree with the need for
mammograms in young women, despite the fact that national
recommendations call for caution. Data analysis also made it possible to
understand the social representations network which encompasses the
risks associated with screening mammograms. However, the
radiation-induced risks seem to be absent from the objectification
process of the sociogenesis of the women's network. This result raises
the question of whether women are indeed well informed about IR-related
risks when deciding to be screened or not (Gesbert, Mamzer, 2016,
screening for breast cancer seems to be part of a global context
advocating early detection to help best define the cancer. Nevertheless,
cancer prevention seems to take priority over providing women with
exhaustive information about the ionizing radiation used in mammograms.
The present work invites us to question health decisionmaking models and
opens up new research perspectives for general practitioners and
gynaecologists, who prescribe mammograms for women under 50 years of