And there are known problems, such as losing patients to follow-up.

"It's not just getting a mammogram that reduces mortality," Williams said. "What studies have shown is you need regular mammograms. If a mobile unit comes to your neighborhood this year, but not next year, are you going to get the mammogram next year? That's a concern."


Some features of the mobile mammography could make follow-up even trickier. For instance, Williams said that because the service is often not tied to a particular health institution, if there's a suspicious finding and a patient needs to go in for additional views or an ultrasound, coordinating with the patient could be harder.

"Institutions that use it need to be aware that it will take some additional legwork to keep up with those patients, compared with those patients who come into a standing clinic all the time," Williams said.

Working with the community
But providers say they're working hard to minimize loss to follow-up. The most important strategy is working with a community partner, such as a church group, city council members or local leaders.

"We don't go into an area without a community partner," Fanus said of Swedish's policies. "Those are the ones these people have the relationship with."

AICF said it's especially important to have a community partner for immigrants, many of whom are served by the foundation's program, as you have to convince them it's not "a ploy to get your address and report that you're undocumented."

Fanus suspects that using these methods, loss to follow-up is quite small, less than one percent of screened patients. Though when it happens, "That's not a good feeling," Fanus said. "It's actually quite scary."

Backlund agrees that it's one of the worst parts. "It's frustrating," she said, "when there's an inconclusive finding from the mammogram, and there's no way to contact the patient."

Paying for care
Of course, most mobile mammography programs are not free. The costs are usually picked up by private insurance or Medicaid, although low-income, uninsured women qualify for federal money administered by state governments that pay for mammograms and cervical cancer screenings and subsequent treatment, Swedish said.

Nonetheless, the convenience of mobile mammography is not only for underserved populations. "Corporations love me," Fanus said.

Swedish has partnerships with Microsoft and Boeing, two major Seattle-area employers, to bring mobile mammography trailers around. At Microsoft, where the coaches go for seven weeks, they screen almost 1,000 women.

More Industry Headlines