Sally Tinkess didn’t plan to get a mammogram.
In her 40s and living on Prince of Wales Island in Southeast Alaska, where health care access is sparse, Sally hadn’t worried much about the need for a mammogram. The clinic where she seeks care is open just six hours a week, and the closest big city is Ketchikan, which is only accessible by airplane or boat.
When Sally’s sister encouraged her to make an appointment with a mobile mammography unit that was coming to Klawock—a town 34 miles west of Sally’s home—she figured it was a good idea.
“If my sister hadn’t mentioned the mobile unit, I wouldn’t have gotten checked,” Sally says.
That was 11 years ago, and the mammogram revealed a spot that was determined to be low-grade duct breast cancer.
The mobile mammography unit is an outreach service provided by the Breast Cancer Detection Center of Alaska. It comes yearly to a clinic in Klawock run by the Southeast Alaska Regional Health Consortium.
When Sally’s cancer was detected, the consortium made her an appointment to have it surgically removed. She flew in and was treated at a hospital in Sitka, Alaska. Two days after her cancer was detected, doctors removed it.
“They caught it from the mammogram,” says Sally, who now makes an appointment to get checked every year. “I never got to think, ‘I have breast cancer.’ It was gone so quick.”
The Breast Cancer Detection Center of Alaska was founded in 1976 and is based in Fairbanks. Its roots came from a need: A woman had a lump in her breast but no access to a mammogram. Nancy Murkowski, whose husband, Frank, was first a senator and then governor of Alaska, founded the BCDC. Several years later, they added a mobile unit to reach remote areas of the state.
“They started out with an RV with a machine in it,” says BCDC CEO Odette Butler.
Today the truck is equipped with 3D tomosynthesis technology.
“It’s the latest and greatest,” Odette says.
The mobile unit is a clinic on wheels with a reception area, waiting room and exam room. The technologist drives the truck and is assisted by support staff during appointments. The unit travels from April to early October. Odette says the imaging equipment is sensitive to extreme temperatures, so a generator is kept onboard for climate control.
“At minus 20 it starts acting funny,” Odette says of the machine.
The truck averages 4,000 miles a year, and staff conduct 800 mammograms. Although BCDC coordinates with local clinics to alert communities it’s coming, Odette says some women simply show up when they see the truck.
A referral is not necessary, and BCDC can bill private insurance, Medicare and Medicaid. Ability to pay is never an obstacle to obtaining a mammogram.
“We don’t turn anyone away,” Odette says. “Once we get there, we see everyone who needs it whether they can pay or not.”
BCDC is funded by revenue from grants, service contracts and local fundraisers. The nonprofit has already started raising money to replace the truck and equipment. The truck gets just 8 mpg.
“Hopefully, it will last another season,” Odette says.
In addition to traveling around remote areas of Alaska, the unit is used at health fairs to educate people about the importance of mammograms and self-exams.
“It takes a certain person to work for BCDC,” Odette says. “You have to be ready to roll up your sleeves and do what needs to be done.”
The mobile unit visits 23 sites around the state. Sometimes the work requires driving through a snowstorm or boarding a barge to reach an Alaskan island.
“Most, if not all of the places, don’t have access to a mammogram,” says Mackenzie Maxwell Smith, BCDC’s marketing assistant.
The need for BCDC’s mobile unit has decreased at some of their older sites as clinics and hospitals acquire mammography equipment. The nonprofit’s primary focus is now Southeast Alaska. Odette says they can add other sites if they can access them.
Pam Sloper is a registered nurse and a clinic lead in Haines, Alaska. The Centers for Disease Control and Prevention fund the clinic and a screening and evaluation program to promote healthy behaviors for women, especially low-income, uninsured and underinsured women.
When the mobile mammography unit plans to visit an area, clinic staff schedule appointments and offer other health screenings at the same time. The Southeast Alaska Regional Health Consortium also provides funding to BCDC to get the truck to remote sites.
“The women can have a one-stop shop,” Pam says.
She chuckles when asked about health care challenges in Southeast Alaska.
“It’s a huge area,” she says. “Most of the towns are not accessible by roads. It’s either airplane or ferry.”
This summer brought a unique challenge when the Alaska ferry union workers went on a 10-day strike, which meant the mobile unit could not make all its rounds.
“This is not a typical summer,” Odette says.
Across Southeast Alaska, the health consortium has clinics in 19 towns, each staffed by mid-level providers such as nurse practitioners or physician assistants. But none are equipped with mammography technology, which means many women don’t get a regular screening.
“They don’t,” says Pam, “unless the truck comes.”
For more information on the Breast Cancer Detection Center of Alaska, visit www.bcdcofak.org.
About the series: This Ruralite-produced series spotlights health challenges, efforts to address them and unsung heroes behind the work. The series receives support from the M.J. Murdock Charitable Trust, which funds projects and programs in Alaska and the Northwest. The Breast Cancer Detection Center of Alaska, featured in the latest installment, received $248,000 for mobile mammography equipment in 2015 and $250,000 for facility renovation in 2017. To learn more about the trust, go to murdocktrust.org.