SEATTLE, Nov. 13, 2008 – Swedish today added a second mobile mammography center to its fleet. The new Breast Care Express, a self-contained trailer, features the latest in full-field digital mammography equipment. And it is the first unit to incorporate a wireless broadband communications system for securely transmitting mammograms from remote sites. A new, state-of-the-art Kenworth T370 tractor donated by PACCAR easily moves the unit to both remote and congested urban sites.
The Express program was created to increase access to modern breast-health services for women in hard-to-serve areas of western Washington. With a second coach, Swedish will double the number of offsite breast-cancer screenings it does each year to more than 12,000.
"Sometimes, women put off mammograms because they live too far from a health-care facility or simply can't take time off work," said Mary Kelly, M.D., medical director for mobile diagnostic radiology at Swedish. "The coaches make rolling house calls with advanced medical technology onboard. Swedish assumes the cost of transportation, so we're able to take personalized services and health education to many under-served populations."
PACCAR's Chairman and CEO Mark Pigott said, "PACCAR and Swedish are leaders in their respective fields. Our working together generates significant benefits to the communities in which we work and live." PACCAR is a leading donor in the Northwest in support of health care, education, the arts and the environment. "We're honored to be able to support the life-saving work done by Swedish every day in the early detection of breast cancer," added Pigott.
The new all-digital coach is one-quarter shorter and designed to be more urban friendly. With a 48-foot trailer, the sheer size of the first Express prevented Swedish from traveling to a number of in-city sites, because of traffic circles and other impediments.
Coach #2's trailer is only 34 feet long, but very similar in appearance to the original coach. Planners only had to give up one dressing room, and it will incorporate a new flat-panel TV for patient-education videos. The coach was built and outfitted at Medical Coaches West in Albany, Ore.
Swedish's first mobile unit started service in April 2004. Since then, it has racked up more than 40,000 miles from the Canadian border to the Columbia River. Coach #1 has traveled throughout western Washington – from Neah Bay, Clallam Bay, Shoalwater Bay and Queets to the parking lots of large urban employers – bringing state-of-the-art digital mammography to women who need it.
In 2007 alone, the Swedish Mobile Mammography Program provided mammograms to 6,271 women, with more than 3,000 done on the Swedish Breast Care Express. After retiring all analog equipment and converting completely to digital imaging, the Mobile Program can offer the same high-quality mammography screenings that are performed in all of the Swedish Breast Care Centers.
The Breast Care Express was responsible last year for the detection of 21 cancers. That equals 3.9 per 1,000 patients screened, with two to 10 per thousand being the national average. Average age at screening was 52.9 years and many women had gone far longer than the recommended 12 months since their last mammogram.
Rudimentary mobile mammography in the Seattle area began as a private enterprise in 1987, with an X-ray unit transported in a converted horse trailer. Providence Medical Center/Seattle purchased that program in 1994 and Swedish acquired Providence Seattle in 2000. So far, more than 70,000 women have been screened.
"Mobile mammography has come a long way in just the last four years," said Albert B. Einstein Jr., M.D., executive director of the Swedish Cancer Institute. "I believe we've demonstrated a serious demand for the service and how best to provide it."
Breast cancer is the second-leading cause of cancer death among women, exceeded only by lung cancer. In 2008, an estimated 780 women in Washington state will die from breast cancer and 4,410 women will be diagnosed with breast cancer. If detected early, the five-year survival rate is more than 90 percent.
The incidence rate of breast cancer in Washington state is 181.4 new cases per 100,000 women, which is highest in the nation. King and Pierce counties are among the most culturally diverse areas of the state, leading to some gaps in and barriers to preventative health care.
"There is still some cultural mistrust of the medical system, health-care providers and services," said Darlene Fanus, supervisor of the Mobile Mammography Program at Swedish. "While the overall mortality rate from breast cancer is declining, African-American women continue to have the highest mortality rate in the state."
The two coaches will operate six days a week and get to many women who haven't had mammograms in three or four years. The units stop at community health fairs, church parking lots, Swedish's primary-care clinics throughout the Greater Seattle area, corporate parking lots and many other sites. To arrange the visits, Swedish always links with a community partner such as the YWCA, Multicultural Health program, African-American Outreach Services, International Community Health Services, Senior Services of King County, the Rainier Park Community Clinic and North Seattle Public Health. Special populations served include Korean, Chinese, Samoan, Filipina, Latina, Russian, lesbian and the homeless.
Swedish works closely with the Family Planning of Clallam County for all of the remote tribes (i.e., Neah Bay, Queets, Lower Elwah, etc.), and the Tulalip and Muckleshoot tribal clinics. The twin Breast Care Expresses will take care of almost all Native American women in western Washington, many of whom live in very rural areas.
In addition to community sites, the coaches travel to corporate parking lots to serve women who find it difficult to take time out of the workday to get a mammogram. Microsoft, Boeing, PACCAR, City of Seattle and REI are some of the companies that partner with Swedish to get women employees regularly screened.
Broad-Based Community Support
Very few fundraising efforts of the Swedish Foundation have garnered more community support than mobile mammography. The program clearly touches people's emotions and 100 percent of the capital costs for the mobile coaches were paid for by philanthropy.
Bellevue, Wash.-based PACCAR, a leading manufacturer of heavy-duty equipment for highway use, donated two brand-new Kenworth tractors and full maintenance packages, with a total value of $250,000. Kenworth built two custom rigs, one at the Renton, Wash., plant and one in Montreal, Canada. The PACCAR Foundation has a long history of contributing to Swedish, but Chairman and CEO Mark Pigott took a particular interest in this project.
Over the past four years, mobile mammography has been the focal point of Swedish's annual Women's Wellness Luncheon fundraising event. So far, the gatherings have generated more than $1 million in contributions, mostly from individuals. Other major donors include the Amgen Foundation, Norcliffe Foundation, Swedish Auxillary and Big Print, which provided the new coach's colorful exterior graphics.
Wireless Communications, Digital Imaging
On the original coach, Swedish employed satellite communications technology. The new coach uses a completely wireless communications system that can securely transmit both data and digital images from virtually anywhere. Industry leader Cisco Systems provided $70,000 in hardware – including servers, switches and routers – plus system integration.
Swedish has invested more than $500,000 in digital imaging technology for each coach. According to an April 10, 2008 story in The New York Times, "About 35.8 million mammograms a year are done in the United States … [and] digital is growing fast. The rush to digital is occurring in part due to the results of the DMIST study, which found that digital technology can provide better cancer detection in younger women with dense breast tissue. Radiologists say that one of digital's advantages is that it lets them adjust features like contrast and magnification, and see things that were blurry or maybe even invisible on film."
From the patient's point of view, a digital mammogram is like traditional film screen mammography. Both use X-rays to generate images of the breast. However, instead of using film to record an image, a digital mammogram uses a special detector to capture and convert X-ray energy into computer-readable data.
Once a mammogram is in a digital format, it can be stored in many ways, retrieved electronically, copied exactly and securely transmitted. From either of the coaches, it takes less than five minutes to send an image to the Comprehensive Breast Center at the Swedish/Cherry Hill Campus for evaluation, with no compromise of image quality.
For more information on the mobile mammography coaches and their schedules, contact Darlene Fanus at 206-320-4760 or via firstname.lastname@example.org.
About Swedish Cancer Institute
The Swedish Cancer Institute (SCI) opened in 1932 as the first dedicated cancer-care center west of the Mississippi. Today, SCI has a presence on all three of Swedish's hospital campuses – First Hill, Cherry Hill and Ballard – as well as in East King County through a new medical oncology clinic in Bellevue. A true multidisciplinary program, SCI offers a wide range of advanced cancer-treatment options in chemotherapy, radiation therapy and surgery – backed by extensive diagnostic capabilities, patient education and support-group services. SCI-managed radiation-therapy services are also offered at Stevens Hospital in Edmonds, Highline Community Hospital in Burien, and Northwest Hospital in North Seattle. The SCI clinical-research arm encompasses industry-sponsored and cooperative group therapeutic trials, cancer screening and prevention trials, and investigator-initiated trials. Breast-cancer screening and diagnostics are available through the Swedish Breast Care Centers and mobile mammography units. SCI patients benefit from an integrated approach to care which takes into account a person's physical well-being and emotional/spiritual needs, too. From prevention and early detection, to state-of-the-art treatments and complementary therapies, to supportive and palliative care, SCI meets the individual needs of each patient. For more information, visit www.swedish.org
PACCAR is a global technology leader in the design, manufacture and customer support of high-quality light-, medium- and heavy-duty trucks under the Kenworth, Peterbilt and DAF nameplates. It also provides financial services and information technology and distributes truck parts related to its principal business. For more information, visit www.paccar.com
- To read a related article posted on The Skanner's Web site on Dec. 4, click here.