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Removing Barriers to Breast Cancer Care

I overheard a breast cancer patient once say:

There is only one thing worse than having cancer – not being able to afford it.


Financial cost remains a barrier to cancer screenings - let alone cancer treatment - among lower income women. While multiple factors contribute to racial and socioeconomic disparities in breast cancer death rates, a lower utilization of mammograms is consistently one of them.

Compounding the problem is the continuing debate over what age and how often women should get mammograms. The American Cancer Society's recommendations remain at odds with the latest by the U.S. Preventive Task Force. The Task Force recommends that routine screenings for average-risk women begin at age 50 and continue to be given every two years, instead of yearly mammograms beginning at age 40.

While the debate continues on, one thing remains constant. Mammograms remain the best, "first-line-of-defense" screening test available for the early detection of breast cancer. 

Guerra_BrooksIn an effort to help women in need and also ultimately save lives, Ari D. Brooks, MD, director of the Integrated Breast Center and Endocrine and Oncologic Surgery at Pennsylvania Hospital, and Carmen Guerra, MD, MSCE, FACP, associate professor of Medicine and associate chief of staff of the Abramson Cancer Center, and president, East Central Division, American Cancer Society, teamed up to create a grassroots program, the Penn Medicine Breast Health Initiative (PMBHI).

“Over the past 18 months, Dr. Guerra and I have worked to build up the Penn Medicine Breast Health Initiative to provide to the underserved and uninsured women of Southeastern PA, access to all our health system has to offer – state-of-the-art breast screenings, diagnostic, and treatment services,” said Brooks.

During this time, Brooks and Guerra partnered with 14 community organizations to help reach and refer women in need for care: Access Matters, Cancer Support Community, Congreso de Latinos Unidos, Esperanza Health Center, Family Practice and Counseling Network, the Greater Philadelphia Overseas Chinese Association, Health Promotion Council, La Communidad Hispana (Chester County), MANNA, Mazzoni Center, Penn Asian Senior Services, the Philadelphia Corporation for Aging, SEAMAAC, and Women and Children’s Health Services located at Pennsylvania Hospital.

To date, over 100 women have been enrolled through the Initiative and already, one woman was diagnosed and started treatment for cancer in October 2014. 

The multi-organizational collaboration is garnering attention and support. Last year the PMBHI received funding from the Pennsylvania Department of Health's Healthy Woman Program to provide breast cancer screening and diagnostic services to 60 women. "The state has steadily increased our funding so that we can now plan on helping an additional 100 women in the coming year," said Guerra.

Even more impressive, the PMBHI was recently awarded $100,000 from the Susan G. Komen Philadelphia Community Grants Program to provide screening and diagnostic services to an additional 400 women this year.

Women coming in through the PMBHI can receive mammograms at Radiology at Pennsylvania Hospital, the Tuttleman Center/Penn Medicine Rittenhouse, or the Perelman Center for Advanced Medicine. Any woman in need of follow-up care is then referred to Dr. Brooks at his office located at Penn Medicine Washington Square.

One huge benefit the Komen funding has afforded the Initiative is the services of a patient navigator, Andrea Nicholson. "Andrea coordinates the screenings for the women, setting up appointments and guiding them through the health care system working closely with the community organizations and our cancer center navigators thereby serving, a vital role in the effectiveness of the program and in providing compassionate care," said Brooks.

From November through February 15th, the PMBHI and its community partners also concentrated on helping women in need get health insurance by helping them enroll in insurance through the Patient Protection and Affordable Care Act. 

"We are indebted to our community partners for finding and encouraging women to come out and get screened," said Brooks. "While our program removes the financial barrier to care, it's our collective efforts that help women overcome barriers of education, language, isolation, child care, disabilities, transportation, prejudice, fear and more."

To help fortify the PMBHI's efforts, Penn Medicine officially joined forces with The American Cancer Society and WUVP Univision 65 in “Amate a ti Misma,” or “Love Yourself,” to provide free mammograms to uninsured women this Valentine's Day. Women who don't have insurance or who have expensive co-pays were able to sign up for a free mammogram in February.   

"Penn Medicine is committed to helping women in need get access to the best breast screening technology and doctors, regardless of their ability to pay," said Guerra. "A healthy community is a strong community and together that's what we're doing, strengthening our community." 


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Views expressed are those of the author or other attributed individual and do not necessarily represent the official opinion of the related Department(s), University of Pennsylvania Health System (Penn Medicine), or the University of Pennsylvania, unless explicitly stated with the authority to do so.

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