Navigation Links
Addressing care gap in underserved women not easy, Mayo researchers find

SAN ANTONIO In an effort to fill a significant gap in the breast care of underserved women, physicians and nurses at Mayo Clinics campus in Jacksonville, Fla., developed a program, still ongoing, to help overcome barriers that prevent women from receiving timely care after an abnormal mammogram.

From 2001 through 2006, Mayo Clinics Multidisciplinary Breast Clinic offered free diagnosis services to 447 women who had been screened for breast cancer by their county health departments in Northeast Florida. The goal was to substantially reduce what can be a long delay between an abnormal screening mammogram and diagnosis which they succeeded in doing and thus improve outcomes for the 38 women found to have cancer and reduce distress in many others.

Arriving at a correct diagnosis was relatively easy; overcoming the barriers to health care that many women have was not, says the lead author and researcher presenting an analysis of the program at the annual San Antonio Breast Cancer Symposium meeting.

For example, many women participating in the program had no address, or just a temporary one, such as a battered womens shelter, says Frances M. Palmieri, M.S.N., clinical manager of the Multidisciplinary Breast Clinic. Few had telephones, public transportation to the clinic was nonexistent, and some women were reluctant to come in any case, Palmieri says. Others could not take time away from child care or work to come to the clinic for evaluation.

This is a snapshot of what happens nationally to financially disadvantaged, medically uninsured women, she says. We all need to understand and try to overcome the challenges and barriers to patient care that exist for many.

Among other things, the Breast Clinic worked with local charities to provide clothing to those who needed it, and worked with the city of Jacksonville to have the public bus service stop at the clinic. They assigned a research nurse, Judith Smith, to help find and bring women into the clinic, which quickly emerged into a full-time pursuit.

It is important that women undergo appropriate diagnostic studies as soon as they receive an abnormal breast cancer screening, but it takes much more coordination than we ever expected, Palmieri says.

Several programs exist nationally to provide free breast cancer screening mammograms to underserved women, but there is no unified system for providing diagnostic services when abnormalities on the mammograms are detected. As a result, in late 2000, Mayo Clinic in Jacksonville and Betty Anne Mincey, M.D., who was at Mayo at the time, instituted a program to address this gap in care. The Breast Clinic worked with health departments in four counties surrounding the institution (Nassau, Duval, St. Johns and Clay), so that women with abnormal mammograms would be referred to Mayo Clinic for a diagnosis. A team of radiologists, led by Elizabeth DePeri, M.D., current principal investigator of the study, worked to provide flexible procedure times and overcome system barriers to offer a timely review of screening films and a rapid diagnosis.

Of the 447 women enrolled through 2006, 65 percent were white, 21 percent were black, and 11 percent were Hispanic. The mean age was 49.7 years. Physicians performed 893 procedures (mostly diagnostic mammograms and ultrasound tests) and found that 90 percent of the abnormalities detected on initial mammograms were benign. They also diagnosed 38 cancers, of which 76 percent were invasive carcinoma that needed immediate treatment. In most cases, county health departments provided that treatment, but some patients were cared for at Mayo Clinic. No data is available yet on outcomes.

The clinic succeeded in reducing what had been a typical delay of several months down to an average of 36 days, well below the 60-day benchmark established by the U.S. Centers for Disease Control and Prevention (CDC), Palmieri says.

This has been a real education for all of us, but our study demonstrates that timely diagnostic resolution of abnormal mammograms in low socioeconomic status women is achievable with a coordinated, collaborative program between an academic medical center and public health departments, she says.


Contact: Paul Scotti
Mayo Clinic

Related medicine news :

1. Cardinal Health, Sentry Data Systems Introduce New Technology to Help Health Care Providers More Cost-Efficiently Care for Underserved
2. It takes a community to address cancer disparities among underserved minority populations
3. Antioxidants show no clear benefit against cardiovascular events, death in high-risk women
4. Work-Family Conflict Dogs Air Force Women After Deployment
5. Work-Family Conflict Dogs Air Force Women After Deployment
6. Antioxidant Supplements May Raise Womens Skin Cancer Risk
7. Early Weight Loss in Women Linked to Dementia
8. For Health Info, Women Often Turn to the Web
9. Smoking increases risks for head and neck cancers for men and women
10. New Study Reports High Injury Rates for Hotel Workers, Even Higher Rates for Women and Nonwhites
11. Passive smoking increases sleep disturbance among pregnant women
Post Your Comments:
(Date:6/25/2016)... (PRWEB) , ... June 25, 2016 , ... The temporary closing of Bruton Memorial Library ... City Observer , brings up a new, often overlooked aspect of head lice: the parasite’s ... for fumigation is not a common occurrence, but a necessary one in the event that ...
(Date:6/25/2016)... ... , ... On Friday, June 10, Van Mitchell, Secretary of the Maryland Department ... in recognition of their exemplary accomplishments in worksite health promotion. , The Wellness at ... Wellness Symposium at the BWI Marriott in Linthicum Heights. iHire was one of 42 ...
(Date:6/24/2016)... , ... June 24, 2016 , ... Marcy was in a crisis. Her son James, ... out at his family verbally and physically. , “When something upset him, he couldn’t control ... use it. He would throw rocks at my other children and say he was going ...
(Date:6/24/2016)... ... ... Topical BioMedics, Inc, makers of Topricin and MyPainAway Pain Relief Products, join The ‘Business for ... $12 an hour by 2020 and then adjusting it yearly to increase at the same ... wage, assure the wage floor does not erode again, and make future increases more predictable. ...
(Date:6/24/2016)... ... 2016 , ... Strategic Capital Partners, LLC (SCP) in concert ... capital for emerging technology companies. SCP has delivered investment events and professional ... than a million dollars of capital investment for five companies. The ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... , June 23, 2016 ... "Pharmaceutical Excipients Market by Type (Organic Chemical (Sugar, ... Formulation (Oral, Topical, Coating, Parenteral) - Global Forecast to ... The global pharmaceutical excipients market ... at a CAGR of 6.1% in the forecast period ...
(Date:6/23/2016)... DUBLIN , June 23, 2016 ... "Key Pharma News Issue 52" report to their offering. ... need in influenza treatment creates a favourable commercial environment for ... and growing patient base that will serve to drive considerable ... flu vaccine would serve to cap sales considerably, but development ...
(Date:6/23/2016)... , June 23, 2016 ... Oticon , industry leaders in advanced ... launch of Oticon Opn ™, the world,s first ... of possibilities for IoT devices.      (Photo: ... Oticon introduces a number of ,world firsts,: ...
Breaking Medicine Technology: