Mobile Van Brings Mammograms to New York City’s Neediest

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 As Project Renewal’s ScanVan staff began early morning mammography appointments, Gina Ricci sat in the van’s tiny waiting area filling out paperwork for her first mammogram.

A family history of breast cancer diagnoses at a young age prompted the 34-year-old singer and actress to make an appointment with the ScanVan. “My grandmother was diagnosed at 44 and my aunt at 28,” she said. Though her mother had undergone previous genetic testing for the disease, and does not carry a genetic mutation, Ricci wanted to get checked.

“I have a child,” said Ricci. “I want to make sure I can be around for her for as long as I can.”

According to a September 2012 estimate done by the American Cancer Society, there have been more than 226,000 new cases of breast cancer so far in 2012. As of Sept. 4, the disease has killed close to 39,500 women in the United States. In an effort to combat the growing numbers, the staff of Project Renewal’s Scan Van travels throughout New York City providing free mammograms to homeless and low-income women often left with little to no access to medical care.

Originally launched in 1987 by Founder and Director, Mary Solomon, the Scan Van began its partnership with Project Renewal in 2007. Project Renewal is an organization that provides employment, housing and healthcare to the homeless, and through their partnership with ScanVan, the mobile clinic parks on street corners throughout the five boroughs every morning and afternoon, 7 days a week.

In 2011, the staff screened nearly 4,800 women—an increase from the 4,500 patients seen in 2010.

“Very often our patients don’t have primary care physicians,” said Mary Solomon, director of Project Renewal’s ScanVan program. “And if they do they don’t have very good relationships with them. We behave as the primary care physicians for these patients and refer them on for free diagnostic work ups.”

The ScanVan staff—including a nurse, x-ray technician and driver—travel throughout the five boroughs to locations listed in the van’s online schedule. Seated behind a desk adjacent to the van’s door, Gina Cintron welcomed patients and entered their information into a laptop. “We see women–Spanish, Black, White, Indian, everyone,” said Cintron. “Last week, we saw about 41 patients.”

Cintron, who does clerical work, is also the van’s driver and Spanish interpreter. The 58-year-old has been driving the ScanVan since 1998, after being recommended to Solomon by a former supervisor at Montefiore Medical Center in the Bronx.

“At that time, Mary needed a woman driver that speaks Spanish,” said the Puerto Rico native. “That’s why I’m here.” Every morning before 7 a.m., Cintron pulls out of a parking garage on 125th Street and Second Avenue in Harlem en route to daily stops.

Patricia Hepburn sat with Ricci and two other patients in the van’s waiting space and discussed cancer education. Hepburn is the Community Outreach Coordinator for Columbia University Medical Center’s Research Recruitment and Minority Outreach (RRMO), a program communicating clinical cancer studies and providing cancer education workshops and seminars to minorities in New York City.

Hepburn, 47, has worked with the ScanVan staff for more than five years. Through RRMO’s partnership with the van staff, she hopes to encourage women of color to be proactive about breast examinations. According to a study supplemented in June 2012 by the Center for Disease Control and Prevention, minority women are diagnosed in the late stages of breast cancer, in part because cancers go undetected.

“I’d hate for [women] to die over something that is so preventable,” said Hepburn. “If they have children, think about your children. Be proactive and get your tests.” After watching her mother and aunt’s battle with the disease, Hepburn became an active promoter of breast health education and aggressive in her fight against breast cancer, and herself gets an annual mammogram.

Solomon, who also has seen cases of breast cancer in her family—her mother and grandmother survived the disease—urges all women to get beyond their fear of mammography and understand the importance of early detection, despite controversy about the consequences. Studies, such as one done by Norwegian scientists in April 2012, have linked mammography to over-detection and over-diagnosis, but many members of the medical community continue to promote it to reduce breast cancer mortality.

ScanVan X-ray technician Debra Thomas has been working with the van since the program’s launch and said the service is useful for the women they serve. “Everyone gets quality service and the best mammograms we can give,” said Thomas, even though she acknowledged a need for equipment upgrades on the van. “Right now we’re using analog, but digital would be great,” she said. “With digital, you can see the image right away.”

Partnerships with organizations such as Avon Foundation, Judges and Lawyers Breast Cancer Alert and Susan G. Komen allows the ScanVan staff to not only give mammograms but also lead patients with positive test results through to the next step of diagnostic testing and treatment.

“We just don’t say ‘well you’ve got something,” said Solomon. “See ya.’ We see it. We can define it for her and then we talk to her about what the next appropriate steps would be.”

“Those women 40 and older are usually covered one way or another,” she added. “Through a cancer services program or through our grant funders or through their own private insurances.”

Cancer Services Program (CSP), a federal Department of Health initiative, provides free cervical, colorectal and breast cancer screenings to men and women. Though funding from the CSP gets Solomon and the ScanVan staff the resources needed to help women over 40, the program does not cover women who are younger—an age group Solomon said is often “left out in the cold.”  The ScanVan’s partnership with the Breast Treatment Task Force (BTTF) creates coverage for women under 40 to be screened and receive coverage if diagnosed with breast cancer.

According to Solomon, more than 3,000 women will develop breast cancer under the age of 30 annually, with risk increasing as a woman ages. Ricci falls within the 30 to 39 age bracket. She left the van thankful for discovering the free mammogram service through her union membership with Al Hirschfeld Free Clinic, a partner of ScanVan.

“We love Mary and the Scan Van,” said Janice Zaballero, executive director of the BTTF. “We have a system set up with two hospitals [Bellevue Hospital and Woodhull Medical Center] women get screening and follow-ups at no cost.”