TY - JOUR
T1 - Comprehensive diagnostic program for medically underserved women with abnormal breast screening evaluations in an urban population
AU - Palmieri, Frances M.
AU - DePeri, Elizabeth R.
AU - Mincey, Betty A.
AU - Smith, Judith A.
AU - Wen, Lonnie K.
AU - Chewar, Deborah M.
AU - Abaya, Reza
AU - Colon-Otero, Gerardo
AU - Perez, Edith A.
N1 - Funding Information:
This study was supported in part by the National Breast Cancer Foundation and Pfizer Oncology and an initial grant from the Susan G. Komen Breast Cancer Foundation. Support for the navigator program was provided by sanofiaventis, Bristol-Myers Squibb, and the Breast Cancer Research Foundation. Funding for this ongoing program is provided by a Mayo Clinic Cancer Center Health Disparities grant.
PY - 2009/4
Y1 - 2009/4
N2 - OBJECTIVE: To institute a patient navigator program for under-insured women to eliminate delays in diagnostic resolution of abnormal screening mammograms, provide services for abnormalities noted during breast cancer screening, describe demographic and clinical characteristics of enrollees, and assess postscreening follow-up care. PATIENTS AND METHODS: Coordinators from area health departments worked with a navigator nurse at Mayo Clinic Cancer Center in Jacksonville, FL, to refer patients for additional diagnostic services, including diagnostic mammography, ultrasonography, ultrasonography-guided biopsy, stereotactic biopsy, breast magnetic resonance imaging, and biopsy guided by magnetic resonance imaging. Women with abnormal screening mammograms (Breast Imaging Reporting and Data System [BI-RADS] category 4 or 5) or palpable suspect breast masses were eligible. Data were extracted from clinical service records. Timeliness of postscreening follow-up was assessed. RESULTS: The study enrolled 447 women from June 30, 2000, to December 29, 2006. Data on the time from screening to diagnosis were available for 399 women, and median time from detection of screening abnormality to diagnosis was 37 days. Time between screening and diagnosis was 60 days or less for 325 (81%) of the 399 women for whom data were available and for 60 (82%) of the 73 women with BI-RADS category 4 or 5 assessments. Both of these percentages exceeded the Centers for Disease Control and Prevention quality benchmark of 75%. Mean time from study enrollment to diagnosis was 2 days for women with BI-RADS category 3 or 4 assessments and 7 days for women with BI-RADS category 5 assessments. CONCLUSION: This program demonstrated a successful collaboration between an academic medical center and community health centers. Most women with BI-RADS category 4 or 5 assessments received a diagnosis within 60 days of screening.
AB - OBJECTIVE: To institute a patient navigator program for under-insured women to eliminate delays in diagnostic resolution of abnormal screening mammograms, provide services for abnormalities noted during breast cancer screening, describe demographic and clinical characteristics of enrollees, and assess postscreening follow-up care. PATIENTS AND METHODS: Coordinators from area health departments worked with a navigator nurse at Mayo Clinic Cancer Center in Jacksonville, FL, to refer patients for additional diagnostic services, including diagnostic mammography, ultrasonography, ultrasonography-guided biopsy, stereotactic biopsy, breast magnetic resonance imaging, and biopsy guided by magnetic resonance imaging. Women with abnormal screening mammograms (Breast Imaging Reporting and Data System [BI-RADS] category 4 or 5) or palpable suspect breast masses were eligible. Data were extracted from clinical service records. Timeliness of postscreening follow-up was assessed. RESULTS: The study enrolled 447 women from June 30, 2000, to December 29, 2006. Data on the time from screening to diagnosis were available for 399 women, and median time from detection of screening abnormality to diagnosis was 37 days. Time between screening and diagnosis was 60 days or less for 325 (81%) of the 399 women for whom data were available and for 60 (82%) of the 73 women with BI-RADS category 4 or 5 assessments. Both of these percentages exceeded the Centers for Disease Control and Prevention quality benchmark of 75%. Mean time from study enrollment to diagnosis was 2 days for women with BI-RADS category 3 or 4 assessments and 7 days for women with BI-RADS category 5 assessments. CONCLUSION: This program demonstrated a successful collaboration between an academic medical center and community health centers. Most women with BI-RADS category 4 or 5 assessments received a diagnosis within 60 days of screening.
UR - http://www.scopus.com/inward/record.url?scp=64749102556&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=64749102556&partnerID=8YFLogxK
U2 - 10.4065/84.4.317
DO - 10.4065/84.4.317
M3 - Article
C2 - 19339648
AN - SCOPUS:64749102556
VL - 84
SP - 317
EP - 322
JO - Mayo Clinic Proceedings
JF - Mayo Clinic Proceedings
SN - 0025-6196
IS - 4
ER -