How one mobile mammography program took on breast cancer in underserved women

Breast cancer is the second most common form of cancer in the world and continues to disproportionately impact lower socioeconomic areas. Authors of a new study analyzed whether a five-year mobile screening program helped the people in these communities who needed it most. 

Researchers led by the University of Texas MD Anderson Cancer Center looked back on more than 9,000 exams performed as part of the Project Valuable Area Life-Saving Exams in Town program, or VALET.

The Houston-area venture—comprised of two screening vans—led to more than 1,600 recalls due to abnormalities, of which 11 proved to be invasive malignancies, authors reported Aug. 4 in Academic Radiology.

“These cases of invasive disease highlight the importance of mammographic screening for a patient population that may not have access to screening,” David A. Spak, MD, with the Houston-based institution’s diagnostic radiology department, and colleagues wrote. “The cancers detected may have progressed to a later stage with worse outcomes and these results support continued mammographic screening for breast cancer in women aged 40–49 years old.”

Mobile mammography has been proven to bolster participation rates, particularly for women in resource-starved communities with limited access. The VALET program has an annual budget of $1.6-$2 million and caters to those who face financial barriers related to travel costs, insurance, appointment availability and the costs of procedures themselves.

Spak et al. retrospectively analyzed 7,391 unique exams undertaken between October 2012 and September 2017. A majority of women screened identified as Hispanic (76%) and averaged 50.6 years old.

After review, most of the 14 findings were small, low-stage cancers. A total of 101 exams were recommended for biopsy—which is the point at which the program no longer funded screening—with 98 going through with the procedure.

Aside from early detection, the authors found the multilingual technologists hired to staff the mobile units improved efficiency, reduced errors and provided patients with a more enjoyable experience.

The project continues to investigate improvements to their offerings, including incorporating digital breast tomosynthesis and breast ultrasound. Spak and colleagues argued their work should prompt similar approaches around the nation.

“These findings support the need for the development of similar programs in other areas in the United States with a mission to care for the underserved community,” the authors concluded. “Additionally, further investigation into mobile mammography programs would be helpful to identify patient factors, logistics, and technology, including DBT, that might prove beneficial.”