According to the American Cancer Society, mammography screening can reduce breast cancer mortality by 29 percent; however, many women in urban and rural areas face time and transportation barriers when attempting to access services. To provide screenings in underserved and never-served communities in Upstate New York, Erie County Medical Center (ECMC) introduced a 45-foot, bright pink mammography clinical office on wheels. The unit not only directly engages patients, but also has drawn on partnerships with community-based organizations to fund and publicize the services. Within its first year on the road, the unit has screened hundreds of women, leading to recommendations for follow-up appointments and breast cancer diagnoses.
According to the Susan G. Komen Foundation of Western New York, Upstate New York had a breast cancer death rate of 24.5 per 100,000 women in 2011, compared with 23.7 statewide and 24 nationally. Meanwhile, there continue to be differences in how breast cancer affects white and black women. For example, the five-year survival rate for black women is 75 percent, compared with 89 percent for white women.
In an effort to expand access to breast cancer screenings, ECMC introduced the Mobile Mammography Unit, which targets women in traditionally underserved urban and rural communities who may not otherwise undergo testing. Specifically, the unit aimed to eliminate the transportation barrier that many women face when accessing mammograms or breast cancer treatment. A Susan G. Komen Foundation of Western New York report identified significant transportation barriers for residents of Buffalo, finding that because the transit system is not streamlined, a large time commitment might be necessary to travel even short distances. Meanwhile, the report found that there is no mass transit option for women living outside the metro Buffalo area, and that women without transportation options are less likely to seek breast cancer services.
Although a few dozen mobile mammography units operate across the country – including in Alaska, Arkansas, Florida, Texas, and West Virginia – ECMC’s is the only unit equipped with two full field mammography systems in two separate testing suites. When the unit is open, two certified mammography technologists conduct the screenings, and then a board-certified radiologist reads the images. A board-certified surgeon specializing in the treatment of breast disease serves as the Mobile Mammography Unit’s clinical director and oversees the care of each patient.
“After meeting with various mobile mammography programs by phone, and because of the enthusiastic foresight of sponsors, we determined that having a [unit] with two suites would permit screening to occur for more women,” says Rita Hubbard-Robinson, JD, director of institutional advancement at the Erie County Medical Center Lifeline Foundation. According to Hubbard-Robinson, up to two women could undergo testing during 15- to 20-minute intervals, allowing up to four patients to be screened per hour.
Community partnerships propel program forward
The Mobile Mammography Unit is sponsored by First Niagara Bank and the Buffalo Sabres Alumni Association, which together with the Lifeline Foundation of ECMC, allocated $750,000 for the unit.
To extend the reach of the program, ECMC partnered with multiple community-based organizations, including the University of Buffalo/MD Community Health Clinics, the Buffalo Municipal Housing Authority, and the National Witness Project. In partnership with these organizations, the unit provides clinical breast exams at clinics, public housing, churches, work sites, community centers, and community-based events, and has been featured during the Erie County Fair.
The National Witness Project has been particularly critical in connecting with women who are over 40 years old, the age at which the American Cancer Society suggests that women begin undergoing yearly mammograms. The project offers programming in churches and community centers led by Witness Role Models and Lay Health Advisors. Witness Role Models are black women who are breast or cervical cancer survivors and who volunteer to “buddy up” with patients who have been diagnosed with breast cancer to discuss their experience and the patient’s fears and concerns. Meanwhile, during the programming, Lay Health Advisors educate patients about both breast cancer and the Mobile Mammography Unit, as well as teach breast self-examinations to attendees. The National Witness Project also convenes weekly with nearly 60 women at local churches to discuss where the Mobile Mammography Unit should stop next.
“The relationship with the National Witness project has provided the Mobile Mammography Unit project with community credibility and value,” Hubbard-Robinson says.
When the project launched in July 2012, ECMC set the goal of screening more than 1,000 women in its first year, and aimed to offer screenings to at least eight sites per month. In the first year, the Mobile Mammography Unit provided 1,410 mammograms, surpassing ECMC’s original goal of providing services to 1,000 women. Out of 1,410 exams, 110 women were flagged for secondary exams, and two positive results were found. The mobile unit has provided services to more than 57 sites and returns to some sites on a monthly basis.
“I am elated to work with a great team to provide this important outreach service,” Hubbard-Robinson says. “I am thankful that we have intervened to save two lives this first year and look forward to more success stories in the future.”
For more information about Erie County Medical Center’s Mobile Mammography Unit, please contact:
Rita Hubbard-Robinson, JD
Director, Institutional Advancement
Erie County Medical Center Lifeline Foundation