Social Work Today E-Zine

In an effort to fill a significant gap in the breast care of underserved women, physicians and nurses at Mayo Clinic’s campus in Jacksonville, FL, 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 Clinic’s 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.

Of the 447 women enrolled through 2006, 65% were white, 21% were black, and 11% were Hispanic. The mean age was 49.7 years. Physicians performed 893 procedures (mostly diagnostic mammograms and ultrasound tests) and found that 90% of the abnormalities detected on initial mammograms were benign. They also diagnosed 38 cancers, of which 76% 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.

Many women participating in the program had no address, or just a temporary one, such as a battered women’s shelter, says Frances M. Palmieri, MSN, 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.

“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 adds.

— Source: Mayo Clinic