scholarly journals Mapping mammography in Arkansas: Locating areas with poor spatial access to breast cancer screening using optimization models and geographic information systems

2020 ◽  
Vol 4 (5) ◽  
pp. 437-442
Author(s):  
Sean G. Young ◽  
Meghan Ayers ◽  
Sharp F. Malak
Keyword(s):  
Breast Cancer ◽  
Travel Time ◽  
Rural Areas ◽  
The United States ◽  
Geographic Information ◽  
Screening Mammography ◽  
Optimization Models ◽  
Spatial Access ◽  
Patient Travel ◽  
Mobile Mammography

AbstractIntroduction:Arkansans have some of the worst breast cancer mortality to incidence ratios in the United States (5th for Blacks, 4th for Whites, 7th overall). Screening mammography allows for early detection and significant reductions in mortality, yet not all women have access to these life-saving services. Utilization in Arkansas is well below the national average, and the number of FDA-approved screening facilities has decreased by 38% since 2001. Spatial accessibility plays an important role in whether women receive screenings.Methods:We use constrained optimization models within a geographic information system (GIS) to probabilistically allocate women to nearby screening facilities, accounting for facility capacity and patient travel time. We examine accessibility results by rurality derived from rural–urban commuting area (RUCA) codes.Results:Under most models, screening capacity is insufficient to meet theoretical demand given travel constraints. Approximately 80% of Arkansan women live within 30 minutes of a screening facility, most of which are located in urban and suburban areas. The majority of unallocated demand was in Small towns and Rural areas.Conclusions:Geographic disparities in screening mammography accessibility exist across Arkansas, but women living in Rural areas have particularly poor spatial access. Mobile mammography clinics can remove patient travel time constraints to help meet rural demand. More broadly, optimization models and GIS can be applied to many studies of healthcare accessibility in rural populations.

National survey of breast cancer screening in rural America.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 13-13 ◽  
Author(s):  
Jeffrey M. Peppercorn ◽  
Kevin Houck ◽  
Adane Fekadu Wogu ◽  
Victor Villagra ◽  
Gary H. Lyman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Rural Women ◽  
Rural Areas ◽  
Univariate Analysis ◽  
College Education ◽  
Screening Mammography ◽  
Screening Methods ◽  
Annual Screening

13 Background: Screening mammography leads to early detection of breast cancer and improved survival. We conducted a survey of predominantly rural U.S. women who receive health insurance through the National Rural Electric Cooperative Association (NRECA) to evaluate the prevalence of annual and biennial screening and to identify potential disparities and barriers to breast cancer screening. Methods: We conducted a national cross-sectional survey of women between ages 40 and 65 who are insured by the NRECA regarding their utilization of mammography screening and barriers to screening. A study specific survey was mailed to 2,000 randomly selected eligible women without prior diagnosis of breast cancer. We assessed demographics and receipt of mammography within past 12 months (all women) and number of screening mammograms within the past 4 years (among women age 44 and older) to identify consistent annual screening and biennial screening patterns. Results: 1,204 women responded to the survey (response rate 60.2%). 74% live in rural areas, 18% suburban, 8% urban. 73% report less than 4 years college education and 19% have family incomes < $50,000/year. Overall, 72% reported screening mammography within 12 months, 59% reported consistent annual screening and 84% reported at least biennial screening. Rural women were less likely to undergo consistent annual (56% vs. 66%, p = 0.003) or biennial screening (82% vs. 89%, p = 0.01) compared to women in non-rural areas. Women under 50 were less likely to report screening within 12 months (67% vs. 77%, p = 0.0002), consistent annual (49% vs. 63%, p < 0.0001) or biennial screening (79% vs. 86%, p = 0.002). Significantly more rural women cited cost and distance as barriers, while busy schedule, fear of diagnosis, and fear of discomfort were important barriers among all demographic groups. Fear of the test was a greater barrier among younger vs. older women (p < 0.02). In univariate analysis; household income did not correlate with screening, and education was only a factor among younger women. Conclusions: A substantial percentage of rural U.S. women fail to undergo screening mammography. Potentially modifiable barriers include out of pocket expenses, convenience of screening, and fear of diagnosis and the test itself.

Mapping Women's World

2018 ◽  
Vol 3 (1) ◽  
pp. 14-25
Author(s):  
Khadijeh Rouzbehani ◽  
Shirin Rouzbehani
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Information System ◽  
Geographic Information System ◽  
Breast Cancer Mortality ◽  
The United States ◽  
Geographic Information ◽  
High Rate ◽  
Background Information ◽  
Research Areas

Feminist geography and geographic information system(GIS) have been the most dynamic research areas over the last decade. Unfortunately, high breast cancer mortality rates have been reported in the northern part of the United states, with recent attention focused on the northern part of the United States. In this article, the authors investigate whether such a high rate of breast cancer is evenly spread in northern parts. The purpose of this article is to provide a more detailed analysis of the breast cancer distribution in the United States by comparing the spatial distribution of breast cancer cases against physical environmental factors using Geographic Information System (GIS). Further, it gives background information to the GIS and its applications in health-related research.

scholarly journals Breast Cancer Screening and the COVID-19 Pandemic

2020 ◽  
Author(s):  
Dana H Smetherman
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Clinical Care ◽  
The United States ◽  
Screening Mammography ◽  
Imaging Studies ◽  
National Organizations ◽  
Screening Mammograms

Abstract The novel SARS-CoV2 (COVID-19) pandemic has had a major impact on breast radiology practices. Initially, nonessential imaging studies, including screening mammography, were curtailed and even temporarily halted when lockdowns were instituted in many parts of the United States. As a result, imaging volumes plummeted while health care institutions worked to ensure safety measures were in place to protect patients and personnel. As COVID-19 infection levels started to stabilize in some areas, breast radiology practices sought guidance from national organizations, such as the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services, and radiology specialty societies, to develop strategies for patients to safely return for screening mammograms and other outpatient imaging studies. Postponement of breast cancer screening has led to delays in cancer diagnosis and treatment that could negatively affect patient outcomes for years to come. In order to continue to provide necessary imaging services, breast radiologists will need to face and overcome ongoing practical challenges related to the pandemic, such as negative financial impacts on practices and patients, the need for modifications in delivery of imaging services and trainee education, and differences in the health care system as a whole, including the shift to telehealth for clinical care. Nonetheless, despite the disruption the COVID-19 pandemic has caused, the need for breast radiology procedures, including breast cancer screening, remains strong.

Effect of Screening Mammography on Breast Cancer Detection and Mortality

2021 ◽  
pp. 164-169
Author(s):  
Myrlene Jeudy ◽  
Monique Swain ◽  
Mark Pearlman
Keyword(s):  
Breast Cancer ◽  
New England ◽  
Late Stage ◽  
Mammography Screening ◽  
Early Stage ◽  
Breast Cancer Incidence ◽  
The United States ◽  
Population Based ◽  
Screening Mammography ◽  
Trend Data

This widely discussed study by Bleyer and Welch published in The New England Journal of Medicine (NEJM) “The Effects of Three Decades of Screening Mammography on Breast Cancer Incidence” concluded that screening mammography leads to a substantial overdiagnosis of early breast cancer (estimated 69% increase) while only having a small effect on late-stage breast cancer (estimated 8% decrease). In a population-based observational study, the authors utilized trend data from the Surveillance, Epidemiology and End Results (SEER) database to examine trends on the incidence and stage of early- versus late-stage breast cancer at the time of diagnosis. They compared 2 time frames: prior to widespread mammography screening (1976–1978) and after mammography screening was introduced in the United States (2006––2008). This article reviews this NEJM article and describes several methodological assumptions by the authors that have been soundly criticized and the associated limitations. As a result of these limitations, there was an exaggeration of the overdiagnosis of early-stage disease with mammography and, more importantly, a substantial underestimate of the impact of mammography on decreasing late-stage breast cancer.

Mapping Women's World

2019 ◽  
pp. 869-881
Author(s):  
Khadijeh Rouzbehani ◽  
Shirin Rouzbehani
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Information System ◽  
Geographic Information System ◽  
Breast Cancer Mortality ◽  
The United States ◽  
Geographic Information ◽  
Background Information ◽  
Health Related Research ◽  
Health Related

Feminist geography and geographic information system(GIS) have been the most dynamic research areas over the last decade. Unfortunately, high breast cancer mortality rates have been reported in the northern part of the United states, with recent attention focused on the northern part of the United States. In this article, the authors investigate whether such a high rate of breast cancer is evenly spread in northern parts. The purpose of this article is to provide a more detailed analysis of the breast cancer distribution in the United States by comparing the spatial distribution of breast cancer cases against physical environmental factors using Geographic Information System (GIS). Further, it gives background information to the GIS and its applications in health-related research.

scholarly journals Model for Early Detection of Breast Cancer in Low-Resource Areas: The Experience in Peru

2018 ◽  
pp. 1-7 ◽  
Author(s):  
Carolyn Bain ◽  
Tara Hayes Constant ◽  
Ines Contreras ◽  
Ana Maria Burga Vega ◽  
Jose Jeronimo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Cancer Detection ◽  
Rural Areas ◽  
Community Outreach ◽  
Northern Region ◽  
Screening Mammography ◽  
Breast Cancer Detection ◽  
Local Health ◽  
Low Resource

Purpose Late-stage breast cancer detection should be something of the past; however, it is still all too common in low-resource areas, including Peru, where 57% of women diagnosed with cancer are diagnosed at stage III or IV disease. Early detection of breast cancer is feasible in low-resource semirural and rural areas where mammography is rarely accessible. Methods PATH collaborated with Peruvian health institutions at local, regional, and national levels to design and implement a model of care for the early detection of breast cancer in Peru. The model includes training health promoters for community outreach, professional midwives in clinical breast exam, doctors to perform fine-needle aspiration biopsy sampling with ultrasound to triage, and patient navigators to ensure patients follow through with treatment. Results In a northern region of Peru, 400 individuals, including health promoters, midwives, doctors, and volunteers, received early-detection training in two phases. In Peru, local health professionals continue to refine and improve methods and materials using locally available resources, and the Peruvian health information system now includes specific breast cancer detection categories. Despite challenges and limited resources, the model is effective, and partnership with government health administrations improves health systems and benefits the population. Conclusion Given the absence of screening mammography, the public health challenge is to bring breast cancer early detection and diagnostic services closer to women’s homes and to ensure appropriate follow-up and care. The model is eminently transferable with appropriate adaptation and should now be tested in other settings within and outside of Peru.

scholarly journals Breast cancer screening during the adverse COVID-19 epidemiological situation

2021 ◽  
Vol 8 (3) ◽  
pp. 34-44
Author(s):  
K. S. Drzhevetskaya ◽  
G. P. Korzhenkova
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Medical Personnel ◽  
Screening Mammography ◽  
Breast Diseases ◽  
Expert Review ◽  
Mobile Mammography ◽  
Mammographic Examination ◽  
Epidemiological Situation

Purpose of the study. To evaluate the results of breast cancer screening (BC) in the conditions of an unfavorable epidemiological situation COVID‑19 based on the analysis of the BC screening project in the Kaluga Region.Patients and methods. Screening system: creation and implementation in practice of mobile mammography complexes (MMC); training of medical personnel in the method of conducting a standardized mammographic examination (ME); quality control of ME; "Cloud" storage and software development for archiving patients; an independent review of mammograms by certified specialists; expert review of images in case of discrepancies in diagnoses; referral of patients diagnosed with BI-RADS IV and V to the regional oncological dispensary for further examination and treatment. From 04.2018 to 12.2020 patients were examined on MMC according to the BC screening protocol. We examined 47367 patients over the age of 40 years. SD 57.66 ± 8.17 years (38-93). During the COVID‑19 pandemic, imaging of breast diseases must be carried out in compliance with all safety regulations for both personnel and patients. Balancing the need to avoid delays in diagnosing BC while preventing infection requires careful attention to personal protective equipment, handling of diagnostic equipment, diagnostic facilities, and physical distancing and vigilance to maintain these measures.Results. From 07.2020 to 11.2020: a total of 10736 studies have been carried out. In the context of new coronavirus infection, we noted an increased demand among patients wishing to undergo BC screening. The flow of patients over the same period of previous years was less, which indicates the demand and justification for screening mammography and the use of MMC in an unfavorable epidemiological situation. 174 patients received category BI-RADS IV-V and were referred for a follow-up examination and required treatment at an oncological dispensary. In 39 patients (22.4 %), BC was verified, and appropriate treatment was carried out. In 135 cases, benign processes were verified.Conclusion. BC screening should not be stopped against the backdrop of the COVID‑19 epidemic since a delay in BC diagnosis later threatens to reveal more voluminous processes with a worse prognosis for treatment and rehabilitation than timely detected changes in the mammary glands in the early preclinical stages of the disease.

scholarly journals Shift in the surgical treatment of non-palpable breast cancer: tactile to visual

2006 ◽  
Vol 9 (1) ◽  
pp. 1-10 ◽  
Author(s):  
K. Dowlatshahi ◽  
J. Dieschbourg
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance ◽  
Needle Biopsy ◽  
Laser Energy ◽  
Color Doppler ◽  
The United States ◽  
Screening Mammography ◽  
Imaging Modalities ◽  
Resonance Spectroscopy ◽  
Breast Cancers

Increasing number of small, early-staged breast cancers are detected by screening mammography. Diagnosis and determination of the prognostic factors may be made by either ultrasound (US) or stereotactically guided needle biopsy. Approximately 2000 stereotactic tables are installed at various medical centers throughout the United States and a significant number in other countries where breast cancer is common. Many surgeons and interventional radiologists are trained in the use of this technology for diagnostic purposes. Employing the same technology, these physicians may be trained to treat selected breast cancers with laser energy percutaneously. Experimental and clinical reports to-date indicate the technique to be safe. High-resolution imaging modalities including grayscale and color Doppler US, magnetic resonance imaging, mammography and needle biopsy, when necessary, will confirm the tumor kill. Newer imaging modalities such as magnetic resonance spectroscopy may also provide additional confirmation for total tumor ablation.

Sign in / Sign up

Export Citation Format

Share Document