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Addressing care gap in underserved women not easy, Mayo researchers find
Date:12/17/2007

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.

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Contact: Paul Scotti
scotti.paul@mayo.edu
904-953-2299
Mayo Clinic
Source:Eurekalert

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