Serving the underserved
The main selling point of mobile mammography is that it brings a service to women who might otherwise not get it. For Swedish, many of the women who benefit live in rural communities and Native American tribal areas, where the nearest breast health clinics could be many miles away. And the underserved don't just live in the hinterland. AICF has fleets that serve the five boroughs of New York, for women who are medically neglected, such as immigrants or the transient. Swedish also has routes through Seattle, serving the underinsured and uninsured, LBGT and the homeless.

"We have a very diverse population in Seattle," Fanus said. "I go to a lot of neighborhood clinics, visiting with interpreters."
For the Northwest, the mobile mammography programs have a special importance, as the region has one of the highest per-capita breast cancer rates - for reasons unknown - even though its screening rates lag behind the national average, around 40 percent versus a nationwide average of 70 percent, Fanus said.

And for the women screened, there's no doubt it makes a difference. Swedish said out of 10,000 exams recently performed, 20 cancers were caught.

The units also offer health benefits, potentially, to more than just the women screened. They could also be used as a "gateway" program to ensure the entire family receives appropriate checkups. As AICF puts it, for many of these populations, the woman drives the family's health care.

"The women we serve are the entrée to care for the rest of their families. If we could find a way through the process of screening women for breast cancer to get their husbands or fathers to be screened for prostate cancer, that would be ideal," Backlund said.

Drawbacks
That said, the providers of mobile mammography recognize its limitations.

"There are a number of obstacles in using mobile mammography," said Mollie Williams, with Susan G. Komen for the Cure, a nonprofit that since 1995 has offered grants which help fund mobile mammography programs all over the country. For starters, Williams said they didn't know of any studies showing mobile mammography resulted in increased compliance and therefore, saved lives.

Plus, it's expensive. Even though with the advent of digital mammography it's easier to do than with film machines, which needed to be constantly recalibrated, it can often be cost-prohibitive for many areas, Williams said. "Those who have benefited from it themselves have been grateful they could get it in their neighborhoods or outside their workplace," she added, "but whether it can really be scaled nationally is something to be determined."

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