Comprehensive diagnostic program for medically underserved women with abnormal breast screening evaluations in an...

Area of Science:

• Oncology
• Public Health
• Health Services Research

Background:

• Delays in diagnostic resolution of abnormal screening mammograms disproportionately affect underinsured women.
• Patient navigator programs can bridge gaps in care for vulnerable populations.
• Early diagnosis is critical for effective breast cancer treatment outcomes.

Purpose of the Study:

• To implement a patient navigator program aimed at eliminating diagnostic delays for underinsured women with abnormal screening mammograms.
• To provide essential services for abnormalities detected during breast cancer screening.
• To characterize the demographic and clinical profiles of enrolled women and evaluate postscreening follow-up care.

Main Methods:

• A collaborative model involving area health departments and a navigator nurse at Mayo Clinic Cancer Center was established.
• Eligible women with abnormal mammograms (BI-RADS category 4 or 5) or palpable breast masses were referred for diagnostic services.
• Data were extracted from clinical records to assess the timeliness of postscreening follow-up.

Main Results:

• The program enrolled 447 women between 2000 and 2006.
• The median time from screening abnormality detection to diagnosis was 37 days, with 81% of women diagnosed within 60 days.
• These timely diagnosis rates exceeded the CDC benchmark of 75%, with most women receiving a diagnosis within 2-7 days of enrollment.

Conclusions:

• The patient navigator program demonstrated successful collaboration between an academic medical center and community health centers.
• The initiative effectively reduced diagnostic delays for women requiring further evaluation after abnormal mammograms.
• This model provides a framework for improving breast cancer screening follow-up care for underinsured populations.