Philadelphia-based Penn Medicine debuted its new mobile mammogram van during a free community health fair on July 13.
The van — equipped with Siemens’ 3D mammography technology in a private, air-conditioned suite — was made possible by philanthropic donations, and federal and community grants, according to a July 7 news release from the health system.
Penn Medicine has partnered with Siemens Healthineers to provide about 1,000 free mammograms through mobile mammography since 2021, though previous events employed a semi-truck to transport a larger mammogram unit, the release said.
Two of the project’s leaders, Brian Englander, MD, and Carmen Guerra, MD, shared with Becker’s more about their goals for the new van and why the system prioritized public health over any potential financial return on investment.
Dr. Englander is the Robert E. Campbell Professor of Radiology and chair of radiology at Philadelphia-based Pennsylvania Hospital, and Dr. Guerra, MD, is the Ruth C. and Raymond G. Perelman Professor and associate director for community outreach and engagement at the Abramson Cancer Center, also in Philadelphia.
Editor’s note: Responses have been lightly edited for clarity and length.
Q: Penn Medicine’s new mobile mammogram van is a major investment in bringing breast cancer screening directly into communities. What were some of the data measures or insights that led you to pursue this initiative?
Dr. Carmen Guerra: The data elements that informed the decision to invest in a new mobile mammography program include:
- Increasing breast cancer rates: Disturbingly, the incidence rate of breast cancer has been rising for decades. In the 1980s, the rise was attributed to the introduction of mammography. In the 1990s, estrogen therapy became widespread and also contributed to the rising breast cancer rates. After a small decline in breast cancer rates in the early 2000s that reflected a decreasing use of hormone replacement therapy, there has been a recent increase in breast cancer incidence over the past decade, which is believed to be related to increased body weight and delayed childbirth.
- More women are eligible for breast cancer screening: In April, 2024, more women became eligible for mammography when the [U.S. Preventative Services Task Force] guidelines lowered the recommended age to begin screening for average-risk women to 40. By lowering the age of when to start screening by a decade, there is a need to expand capacity to accommodate the women that are now eligible to start screening at age 40.
- Mammography rates are still suboptimal: Although Penn Medicine has state of the art mammography facilities at multiple locations including in downtown Philadelphia and the suburbs, mammography screening rates remain suboptimal in the 13 county Abramson Cancer Center catchment area for women age 40 years and over at 74.5%.
Penn Medicine wants to help women detect breast cancer early when it is most treatable by making mammography more accessible. The mobile unit will allow us to meet women where they live, work, worship and even shop!
Q: Are there particular populations or geographic areas you’re targeting with this initiative? How will you track progress in reaching them?
CG: The Abramson Cancer Center carefully tracks incidence, mortality and, importantly, late-stage cancer in each of the 13 counties that comprise its catchment area. Late-stage cancer is an indicator of where mammography is needed most because when mammography is performed regularly, it can detect cancer at an earlier stage.
Consequently, we will seek to establish partnerships with community organizations and residents of those counties to be able to co-develop a plan to offer mobile mammography, especially in the counties that have a disproportionate share of late-stage breast cancers. We will continue to analyze the cancer registry data from the CDC annually to monitor our progress in reducing late-stage breast cancers.
Q: Investing in a dedicated mobile mammography unit is a significant capital decision. How did Penn Medicine weigh the return on investment, both in terms of clinical outcomes and long-term health system goals?
Dr. Brian Englander: Penn Medicine invested in mobile mammography as part of its ongoing commitment to investing in the region where it offers standard imaging services. In addition, there was a successful partnership supported by Penn Medicine and Siemens Healthineers between 2021 through 2024, that revealed a higher cancer detection rate than expected.
Senior system leadership and the radiology department understand the need to reduce obstacles to access and decentralize care. Consideration about the financial return on investment was less important than the philanthropic impact of providing mobile imaging. The intent was to ensure that patients in the Penn catchment have access to screening mammography regardless of insurance status. Public and private partnerships are being established, as well as collaboration with industry and community organizations, to ensure access to the healthcare system for all breast care.
Q: How will you define and measure success for the mobile mammography program? Are there specific benchmarks or community health indicators you’re aiming to improve?
BE: Although precise metrics have yet to be determined, success translates to providing screening mammography for women over the age of 40 who have never had a mammogram before or have not had a mammogram within the past two years. Screening mammography will be offered at the same locations each year so that annual routine mammography can be achieved.
At a minimum, the mean cancer detection rate will be the same for mobile mammography patients, with anticipated higher numbers given a previously unscreened population. All metrics as established by [the Mammography Quality Standards Act] will be indistinguishable between mobile and hospital-based mammography, as will quality, experience and outcome measurements. In addition, the translation of screening mammography to participation in healthcare management will be assessed.
