Screening Saves Lives

Breast Health Screening The Right to Know

Breast Cancer & Disability

One in five women in the U.S. has at least one disability.
Historically, women with disabilities have been marginalized and disadvantaged, especially with regard to health care access.
Compared to women without disabilities, women with disabilities have an equal or greater risk of having breast cancer.
Women with physical disabilities are significantly less likely to have had recommended breast cancer screenings.
Fewer or inconsistent screenings put women at risk for late-stage cancer diagnosis and poor health outcomes.

Factors contributing to successful breast health screening for women with disabilities

Access to public or private transportation
Access to the facility: zero step entrances; automatic front door; wide interior doors and halls; low reception counters; large waiting, examination and dressing rooms; accessible bathrooms.
Adaptable medical equipment: wheelchair-friendly mammography machines, mammography chair, adjustable height exam table, etc.
Designated ADA parking spaces for cars and lift-equiped vans at the front entrance.
Disability training for health care providers.
Insurance coverage

Accessibility & Equipment

Americans with Disabilities Act (ADA):
- Accessibility Guidelines
- Access to Medical Care for Individuals with Mobility Disabilities
- Assessments and Tax Incentives
- Communicating With People Who Are Deaf or Hard of Hearing in Hospital Settings
Medical Equipment: When purchasing new equipment, consider buying wheelchair-friendly x-ray units, and specialized mammography positioning chairs.
Montana Centers for Independent Living (CILs)
Montana Mammography Directory: Information about mammography facilities by city for individuals and service providers: hours of operation, bus routes, average costs, and accessibility details. Updated annually.
North Carolina Office on Disability and Health: Removing Barriers to Health Care: A Guide for Health Professionals. A resource of making medical facilities accessible.

Training & Education

American Congress of Obstetricians and Gynecologists (ACOG):
- Reproductive Health Care for Women with Disabilities.
- Improving Access to Care for Women with Disabilities: Quick Reference on CPT Coding: For more information email: underservedwomen@acog.org
Breast Health Access for Women with Disabilities (BHAWD): Offers Mammography Technologist Training on screening women with disabilities.
CDC's Right to Know Campaign: Offers health promotion materials to increase awareness of breast cancer among women with physical disabilities and to encourage these women to get screened.
Every Woman Matters: Portraits of Montana Women Living with Physical Disabilities. A multi-media exhibit highlighting the importance of Breast Cancer Screening.
MammaCare: Provides tactually accurate breast models and evidence-based certification courses in performing and teaching Clinical Breast Examination and Breast Self-Examination. 800-626-2273
Montana Cancer Screening Program: Provides low cost or free mammograms, clinical breast exams, Pap tests, and pelvic exams for eligible individuals. 888-803-9343.
Registry For Interpreters For The Deaf
Women's Independence Through Health ~ Universal Screening Solutions
Women Be Healthy: A curriculum designed for women with intellectual and developmental disabilities.

Health Care Provider Screening and Facility Tips

Schedulers should ask a patient if she ...

needs accommodations - extra time or assistance.
uses a wheelchair or scooter.
has a wheelchair with moveable or removable arms.
can sit upright without back support.
can lift her arms to shoulder height.
can independently transfer to another chair.

"People First" Communication

Regardless of her disability, speak directly to the patient, not to her companion or assistant.
Refer to the patient as a ...
- woman/patient/person with a disability, not a disabled woman.
- woman/patient/person who uses a wheelchair/scooter/walker, not a wheelchair-bound woman.

The Mammogram

If necessary, ask another technologist to help with positioning.
Use adaptations or alternate views to maximize tissue visualization.
Work with the patient to find the best positions.
The patient is the expert in her abilities; ask for directions and listen to her instructions.
If the patient prefers, include her companion or assistant during positioning.

Portions of this material have been adapted, with permission, from the Florida Office on Disability and Health's Radiology Professionals Tip Sheet.

Montana Disability and Health Program, The University of Montana Rural Institute, 52 Corbin Hall, Missoula, MT 59812-7056; 888-268-2743; 406-243-5467 (V); 406-243-4200 (TTY); 406-243-2349 (fax) matraci@ruralinstitute.umt.edu; http://MTDH.ruralinstitute.umt.edu; http:///www.CDC.gov/righttoknow Opinions expressed are the author's and do not necessarily reflect those of the funding agency