St. Vincent Healthcare
Billings, Mont.

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The St. Vincent Healthcare Mobile Mammography Coach was started in spring 2010 with funds from the SVH Foundation to support breast cancer screenings for under- and un-insured women in the SVH service area, with special emphasis on Montana's American Indian Women. By bringing this service to these populations, our goal is to educate on breast health and detect cancer in the early stages.

Only three American Indian Reservations in Montana have the capability of performing mammograms on-site. Currently, American Indian women wait up to six months for a mammogram. In addition, Indian Health Services has minimal resources available for breast health services. Diabetes, AIDS, heart disease and accidents take priority for healthcare education and dollars. All of these issues contribute to the fact that American Indian cancer patients have the poorest survivorship from cancer five years after diagnosis when compared with other minority, poor, and medically underserved populations in the nation. Within the last few generations cancer has become the second leading cause of death among American Indian women

In the first nine months of operating the Mammography Coach (April 2010-January 2011), St. Vincent Healthcare provided mammograms to 1,082 women in eastern Montana. First-time screenings were delivered to 135 women, of which 61.48 percent were between the ages of 40 and 49. Patients originated from communities throughout Eastern Montana, ranging from Glasgow, Winnett, Lodge Grass, to Ashland and Lame Deer. Below is an analysis of the first 800 women served:

We diagnosed seven breast cancer cases in the first 800 patients (seven months of the mobile service). These cancers were found on four Native Americans and three non-Native Americans, ages ranging from 53 to 84. Seven cancers is a disproportionately high number for this number of screenings. With mammography, a certain percentage of patients are "called back" for a diagnostic mammogram. National quality of care guidelines for mammography facilities are a callback rate of 7 percent. Out of every 1,000 women screened, 70 would be called to return for a diagnostic mammogram. Of this 7 percent, (70 patients) 5 percent are diagnosed with cancer (3.5). With 800 patients, the expectation would be that approximately 56 women would be called back, and less than 3 patients would have cancer. Seven cancers would not be expected to be diagnosed until 2000 patients had been screened. The fact that seven women were diagnosed is more than twice the national average. The higher number of diagnosed cancers is most likely because many of the women screened did not receive routine mammography. As a result, these cancers were diagnosed at a later stage than they may have been had access been more available. The high rate of cancer diagnosis has shown that the increased screening for rural women and American Indians is having an impact.

The mammography coach will begin its second year of operation in April 2011 with the continued goal of enhancing the ability to improve patient access to services as well as address the current critical gap in patient care in outlying areas. It will continue to promote and deliver mammograms as well as provide breast health education to those in the communities visited by the coach.

Relationships are established and we will continue to serve the Billings Area Indian Health Services (IHS) and the Montana Migrant and Seasonal Farmworker Council, Inc., (Migrant Council). This will advance or mission of providing services to diverse populations, with the most advanced technology, regardless of their ability to pay.

Contact for Mammography Coach:
Pat Grimsley, Yellowstone Imaging Supervisor, (406) 237-4265