YNHH increases access to mammograms through mobile imaging unit
Yale New Haven Health seeks to bridge gap in healthcare access for women in Connecticut by providing mammograms in a mobile screening unit.
Jenny Huang
Over the past four months, Yale New Haven Health’s mobile breast imaging unit has traveled to various Connecticut towns, providing 3D mammograms to women in underserved communities.
In November of 2020, the hospital acquired a van and launched the unit, aiming to provide women across the state with increased access to mammography and ultrasound scans. According to Elizabeth Berger ’07, assistant professor of surgical oncology at the Yale School of Medicine and a physician at The Breast Center at the Smilow Cancer Hospital in New Haven, the pandemic caused a dramatic decrease in mammography visits because patients were worried about visiting a hospital. The van, as a mobile unit that can travel to communities, aims to incentivize patients to receive their mammogram by removing the need to visit a hospital.
“What we know about mammograms is that they significantly decrease the rate of mortality for breast cancer,” Berger said. “The ongoing COVID protocols at the hospital affect the number of mammograms we can complete in a day. … The van will increase access to care.”
Berger told the News that recommendations for the frequency of mammography screenings vary between different medical groups. However, the general recommendation for women with average risk, meaning no previous or family history of breast cancer, is to schedule their first mammogram at age 40 and continue annual screenings.
Mammograms are especially important because they can detect breast cancer in its earliest stages. Early detection is critical when determining patient outcomes in breast cancer, according to Berger.
“We know that early diagnosis increases survival,” Melanie Lynch, director of breast surgery at The Smilow Cancer Hospital Care Center at Bridgeport Hospital, told Connecticut Style on WTNH.
Berger told the News that the van is one of the ways in which oncologists are seeking to individualize patient care. Not all women have the same risk factors and needs in terms of screening mammograms, and not all women have the same access to mammography. In general, health care is a finite resource, and the hospital centers are not able to accomodate all of the women who need mammograms. The van seeks to bridge the access gap across different communities.
Patients must meet certain conditions before receiving their screening. First, the patient must be at least 40 years old. Second, screenings are only offered by appointment, due to the pandemic. Third, all patients must complete a follow-up ultrasound.
“Connecticut is a state that allows ultrasound screening irrespective of your breast density and risk,” Berger said. “Ultrasounds increase the sensitivity of the screening and decrease the false negative rate.”
Since the beginning of its operations, the van has also received attention from government officials. According to the New Haven Independent, Susan Bysiewicz, lieutenant governor of Connecticut, visited the mobile unit in November 2020 and encouraged women in Connecticut to receive routine breast cancer screenings. State Rep. Toni Walker and Sen. Paul Ciccarella both provided statements in support of the hospital’s new initiative to News 8 WTNH.
Berger also told the News that the past year has seen a dramatic drop in the number of mammograms and screening ultrasounds performed on patients. She attributed this decrease to the general fear surrounding the idea of entering a hospital during a pandemic and noted a resurgence of this apprehension due to the spread of the Delta variant this fall.
According to Berger, many women also chose to defer their annual mammograms for fear of receiving a false positive caused by a side effect of the COVID-19 vaccines. In provoking an immune response, the vaccine triggers swelling of the lymph nodes, some of which are located in or near the breasts. On mammograms, these swollen lymph nodes would be flagged as potentially cancerous masses. However, several months after initial vaccination, swollen lymph nodes should not be an issue.
The mobile breast imaging unit will be at the YNNH’s Uncasville Medical Center of the Mohegan Sun Group on Nov. 17.