‘It Saved My Life’

There is always a reason to postpone a mammogram. Things are busy at work, and getting time off can be challenging. Kids and grandkids need you. Various commitments fill your calendar.

But no matter how busy a woman is, once she hits a certain age, her mammogram is an important appointment to keep. Mammograms use low-energy X-rays to screen for the presence of breast cancer. The sooner breast cancer can be found, the more options a woman might have for treatment – and with better chances of survival.

Since 2006, UT Southwestern’s Mobile Mammography Unit has been working to make this potentially lifesaving breast cancer screening more convenient for women.

Mammograms Made Easier

Heather Ashby is a busy working woman who says UT Southwestern’s Mobile Mammography Unit saved her life. In fact, she almost skipped her mammogram. After all, her previous mammograms had all been normal, and she didn’t have a family history of breast cancer.

But Mrs. Ashby’s employer regularly arranges to have the mobile unit come to her work location. So, as she had done for several years prior, she made her appointment. A few days later – just two days before she planned to leave for a vacation to Greece – she learned the mammogram had detected an abnormality.

The next day, she contacted the Harold C. Simmons Comprehensive Cancer Center at UT Southwestern for further testing, and after returning from her tour of Greece, she had a lumpectomy.

“I have an excellent prognosis because of the early detection,” Mrs. Ashby says. “Truly, the mobile mammography unit saved my life.”

Phil Evans, M.D., a diagnostic radiologist and Director of UT Southwestern’s Center for Breast Care, is guided by a philosophy of patient-centered care, embracing the idea that every patient has different needs. And while a mammogram is the gold standard for breast cancer screening among women, every woman’s work and life commitments vary.

“The advantage of mobile mammography is that the service is brought to the woman,” says Dr. Evans, a Clinical Professor of Radiology. “The mobile unit offers the opportunity for working women to have a potentially lifesaving screening in a relatively short amount of time, rather than having to leave work and drive to a facility.”

The mobile unit contains the same mammography unit and quality of screening that’s in the UT Southwestern Center for Breast Care, an American College of Radiology Breast Imaging Center of Excellence.

“The exam results are provided by the same UT Southwestern physicians who read mammograms conducted at the (Cancer) Center,” Dr. Evans adds. “They are all highly trained diagnostic radiologists, specializing in breast imaging only. This adds to the patient-centered care that women get.”

And the cost considerations are the same, too.

“If your insurance pays for a screening at a facility, it will also pay for a mobile unit,” Dr. Evans says. “It’s a good deal because it comes to you. The screening is done in a quick, efficient manner, and you get your results rather quickly as well.”

Benefits of Screening

Some women may have anxiety associated with getting a mammogram. But for many women, the breast compression is only mildly uncomfortable, not painful. And the vast majority of women get a healthy, normal report afterward.

“The chance of any given woman having breast cancer is relatively small,” Dr. Evans notes. “Mammography is extremely cost effective as a screening tool. Since 1990, when it became used more in the population, the breast cancer death rate has dropped by 40 percent. That’s a huge improvement in population health.”

Women with a high-risk family history for breast, ovarian, colon and uterine cancer who qualify for hereditary cancer risk assessment are now routinely identified at their annual mammography appointment. The breast and cancer genetics programs are united in the effort to flag these concerning family history cases via the newly established UT Southwestern mammography patient navigator.

Effective April 2018, the navigator receives reports on patients with family history that meets national criteria for referral to genetic counseling or testing. She contacts the patient to clarify the family history, educate on importance of cancer genetic counseling, and schedule a genetic counseling appointment. The navigator also receives data on the patient’s lifetime breast cancer risk estimate based on the reported family history of breast cancer. In qualified higher-risk cases, she will introduce the possibility of an increased breast cancer regimen and referral for consultations to achieve maximum risk-reduction. The mammography navigator position is unique in North Texas and helps the breast program achieve truly comprehensive patient care.

That’s because when cancer is identified earlier, it can be treated earlier. Left untreated, a tumor in the breast can grow and even spread to other parts of the body, requiring more complex treatment.

“We know screening mammography reduces mortality from breast cancer by about 35 percent,” Dr. Evans says. “That means you have a greater chance of not dying if the cancer is found via screening.”

He adds that only about 60 percent of at-risk U.S. women get mammograms on a regular basis and notes that increasing that number to 80 percent or more could have an impact on women’s lives.

Scheduling the Mobile Unit

To help ensure women don’t skip their mammograms, UT Southwestern’s mobile breast center coordinator reaches out to corporations, schools, government offices, and other large employers. Together, an employer and UT Southwestern agree on a date (or multiple dates) for the unit to visit and begin accepting appointments. The mobile unit can accommodate up to about 40 appointments a day.

“Most employers are very happy for their female employees to have the test to make sure their health is good,” Dr. Evans adds. “It takes only about 10 to 15 minutes away from work.”

Shannon Radford, Wellness Director at Presbyterian Village, where Mrs. Ashby works, says managers recognize how hard it can be for working women and others to make time for screening. Since initially scheduling the unit for the company’s employees, organizers have expanded opportunities for residents as well. “When the unit is on campus and staring at you, it’s almost like, ‘I have to do this. It’s right here. Why would I not just make an appointment?’”

At the end of each day, the unit transmits the breast images to UT Southwestern. If the results are normal, women receive a letter in the mail. If an abnormality is found, UT Southwestern calls the woman to schedule follow-up appointments.

To date, 591 patients have been screened for breast cancer at the unit, and Mrs. Ashby is grateful for her own mobile unit experience.

“I was arrogant in thinking that breast cancer wouldn’t touch me and that I could maybe miss this appointment and get it done later,” she says. “I will forever be telling people how important it is to get your mammogram every year. Women need to know that. Our mothers need to know that. Our daughters need to know that.”