Telemedicine improves breast screenings for rural Indian reservations

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.