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Objective:
According to the American College of Radiology, minority women are 72% more likely to be diagnosed with breast cancer under the age of 50 and 127% more likely to die from breast cancer under the age of 50. Mobile mammography vans can increase rates of screening and follow-up for medically under-served women who are unable to access care. One barrier to implementation includes the cost-effectiveness and longevity of mobile mammography units due to the need for long-term funding, equipment and employment. Our objective is to explore an alternative way to fund and establish a mobile mammography program using our current tertiary care academic institution’s proposed model, highlighting characteristics that would maintain longevity and financial support.

Materials and Methods:
Using institutional Librarian services, an Embase search was performed to review the current literature on mobile mammography van programs throughout the United States, providing a framework for subsequent interviews. Our tertiary care academic medical center aimed to design a self-sustained mammography van program, and we conducted interviews of those delegated to leadership positions. Three clearly defined branches of leadership included an administrative branch, medical branch and a third-party mobile mammography branch. Each leader was interviewed to obtain their outlined plans for the specific delegated portion of the program: the Chair of Oncology was interviewed as head of the medical branch, the VP of Clinical Operations was interviewed as head of the administrative branch, and Executive Administrator in the Dept. of Radiology was interviewed for the specific financial plan. The Chair of the University’s Radiology department was interviewed as the facilitator of the three branches and coordinator with the third-party mobile mammography unit.

Results:
Organizational flowcharts were created. Diagrams delineating budget distribution showed incremental transition away from screening the primarily insured patient populations toward screening primarily uninsured. This design creates an infrastructure for providing care to under-served patients while preserving financial stability after three years. Patient workflow and daily processes were illustrated in additional figures, demonstrating feasible and timely management of patient care. A patient follow-up model showed that appropriate care can be achieved by a thorough, structured and coordinated care plan. Medicaid policies on breast cancer care were considered in planning appropriate follow-up for under-served patients.

Conclusion:
Mobile mammography van programs can aid in increasing rates of screening and decreasing breast cancer burden in women from medically underserved communities. This model highlights one way to achieve sustainability, contributing to earlier breast cancer diagnosis, improved care and streamlined follow-up. By highlighting how a successful model may look, replicating this model could provide more outreach in other areas of the country, reducing the number of late-stage diagnoses and deaths from breast cancer in medically underserved women.