Catholic Health World Articles

The pink card that nurse and oncology navigator Skarlleth Kauffmann hands out to women is more than just a card, she likes to say.

“I always tell them: ‘This pink card can save your life,’” she said.

The card, printed in English, Spanish and Creole, explains how women in Broward County, Florida, who meet the program’s eligibility requirements can call to make an appointment for a free mammogram. The Holy Cross Health’s Partners in Breast Health program is part of the system’s community health and well-being department, which works to improve health equity. Screening and diagnostic services are provided at the Holy Cross Dorothy Mangurian Comprehensive Women’s Center in Fort Lauderdale. Holy Cross Health is a member of Trinity Health.

“The free mammogram is the start,” Kauffmann said. “But we also have the warning signs, and the phone number they can call. I start doing the intake, the little interview, and this is how all the processes start.”

The program, which started in 2011, is for low-income, uninsured, at-risk women 40 or older and women 40 or younger with a family history of breast cancer or who are experiencing symptoms of breast cancer. If a patient is diagnosed or needs treatment, the program links them into care and navigates them through the health care system.

Partners in Breast Health was started by a grant from the American Cancer Society. Since then, it has received funding from the Florida Breast Cancer Foundation, the Susan B. Komen Foundation, and Women Owning Wellness (a committee of the Holy Cross Hospital Auxiliary). Today the program is funded by the Harry T. Mangurian Jr. Foundation, local philanthropists, community organizations and private donors.

Of the 800 women who get screened through the program each year, about two or three a month are diagnosed with cancer and start treatment, Kauffmann said. Many are immigrants and do not speak English.

Research shows Black and Hispanic women face significant breast cancer health disparities compared to white women, including getting diagnosed at a later age and having higher rates of aggressive breast cancer and mortality.

The women’s main challenge is financial, Kauffmann said, along with low health literacy. There is also a stigma in Latin cultures about touching one’s own breasts to check for lumps or changes, she pointed out.

“It’s something we need to change, how we’ve been programming that we need to get familiar with our bodies,” said Kauffmann. “You can be able to see what is normal and what is not normal for you.”

Fear also deters patients from getting care. Kauffmann recalled the story of a 38-year-old woman from Jamaica who noticed a wound on her breast and had tried to treat it herself. She came down with a fever and felt so sick she went to the emergency room. A biopsy detected breast cancer, and doctors found it had metastasized to her lungs.

“You can imagine how afraid they are, first of all for their life, because they are thinking, this is it,” said Kauffmann. “They also think, ‘What is going to happen with my kids? They depend on me for work. How will I be able to help them?’”

Kauffmann talked to the woman, who then disappeared for about three months, avoiding calls and efforts to contact her. She ended up back in the emergency room. “I went back and talked to her, and we were able to put her into care. We were able to help her,” said Kauffmann.

The woman had a double mastectomy and treatment and is doing “very, very well,” Kauffmann said. “She said to me, ‘Thank you, because you never gave up on me, and you always tried to guide me.’”

If women need help getting to appointments, Kauffmann will assist them in arranging transportation. If they need food, Kauffmann will connect them with food pantries.

“It is not only about the disease,” she said.

The patients worry about their small children, or for their own aging parents or grandparents. Those relatives need support after the diagnosis, too, Kauffmann pointed out.

If necessary, the program supports women who need palliative or hospice care. Kauffmann shared the story of a woman from the Dominican Republic who was diagnosed with breast cancer that had spread to her brain and bones. Her dying wish was to get married to her boyfriend of more than 20 years. Kauffmann talked to her supervisor and a chaplain, and they arranged a wedding for the couple on the beach.

“She was able to have the dream that she wanted, and she died six months after that,” said Kauffmann.

Kauffmann goes to schools, parks, health centers, health fairs and senior centers to tell people about the program. Clinics around Broward County and other providers also refer patients.

Rodriguez, who came to the United States from Colombia 20 years ago, heard about Partners in Breast Health through her church. The 56-year-old got a mammogram after feeling a lump in her breast. When she learned in January 2024 that the lump was cancerous, Rodriguez said she felt overwhelmed and afraid of what might be involved in her treatment.

“Only God gave me the strength to continue,” she said in Spanish as Kauffmann translated.

Rodriguez had a mastectomy a few months later and is now cancer-free. “The care the program is giving to me is very valuable, because it’s a very scary moment to go through,” she said. “I was able to feel that I am not alone, and that the program was able to support me all the way. I don’t know what I would do without them.”

Rodriguez is part of a group of women in the program who stay connected through a texting app. The group also meets virtually and in person for support and, yes, fun. Kauffmann makes sure they celebrate Valentine’s Day and Mother’s Day as a group, and she even dresses up as Santa to give gifts to them and their families for the holidays.

The women come from many countries and speak different languages, and they translate for each other, draw pictures, or use Google translate to communicate.

“They figure it out,” said Kauffmann. “It’s the sense of community, the sense of family that helps make them not feel lonely. Sometimes it is the language of love and the language of care that is more important.”