Telemedicine improves breast screenings for rural Indian reservations

Ann Arbor 03 December 2006Native American women who live in North Dakota and South Dakota are coming to the University of Michigan Comprehensive Cancer Center for their mammograms without ever leaving the reservation. University of Michigan radiologists sought to improve delivery of traditional mobile mammography, in which a large truck equipped with mammography machines travels to various sites. Using digital mammography instead of films and adding satellite capability, they found the digital mammograms could be beamed to radiologists who could read them in Ann Arbor, Michigan.


"Mobile mammography is a critical way for Native American women to get a mammogram. But what happens when a woman needs to be called back for more images? By transmitting the mammograms by satellite, a radiologist could read them on the spot and three-quarters of the women who needed more images had those done immediately or within fewer than three days", stated Marilyn Roubidoux, M.D., professor of radiology at the University of Michigan Medical School. Dr. Roubidoux is presenting the results of this pilot programme at the annual meeting of the Radiological Society of North America.

From March to July 2006, a mobile mammography unit owned by Indian Health Service visited seven American Indian reservations in North Dakota and South Dakota and performed 515 digital mammograms. The digital images were then transmitted via satellite to radiologists in the Breast Imaging Division of the University of Michigan Radiology Department. The average time between sending the films and obtaining a report for these women was 50 minutes. In ideal technological and weather conditions, it was as quick as 30 minutes.

Of the 58 women who needed additional images, 72 percent were able to get those tests done immediately, or returned within three days for more imaging. Radiologists found the mammogram images transmitted via satellite were of excellent quality, on par with the digital mammograms they read daily in the University of Michigan Breast Imaging Clinic.

Only about 10 percent of Native American women over age 40 get a yearly mammogram. In many cases, women live on rural reservations where they must drive as far as 100 miles to have a mammogram. After the test, it can take up to a week before a woman receives the results. If additional tests are needed, it is often difficult to arrange for that follow up.

"What I used to have to do is drive about 90 to 100 miles to get a mammogram done", stated one Native American woman who participated in the mobile mammography. "It was real convenient to have that unit come directly to our hometown. There are a lot of women in our town who need to have the mammograms done that usually don't come."

The Indian Health Service plans to implement this service again in 2007, with collaboration from the University of Michigan Breast Imaging Division. Dr. Roubidoux is a member of "the Spirit of Eagles", a leadership network to promote cancer control research among Native Americans.

In addition to Dr. Roubidoux, University of Michigan study authors were Mark Helvie, M.D.; Caroline Blane, M.D.; Steven Haugen, M.D.; Kate Klein, M.D.; Chintana Paramagul, M.D.; Alexis Nees, M.D.; Janet Bailey, M.D.; and Annette Joe, M.D. Additional authors were Edgardo Gimenez, M.D., of the Mayo Clinic and from the Aberdeen Area Indian Health Service: Tina Russell, Wileen Druley, Jackie Quisno, M.D., Tony Stayner, Maggie Oyler, Ray Stands, and Sarah Dye, M.D.

Leslie Versweyveld

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