Big Bend area health officials are continuing to contract with a mobile mammograms provider despite initial patient and provider complaints and a formal investigation into a high number of inconclusive results from screenings in May.
Without mobile mammography events local patients would have no choice but to travel hours away to receive the routine exam — recommended annually for all women over 40, or even younger for those with a family history of breast cancer.
“It's tough for a woman to take off a full day of work, or time away from kids, to get basically about a 20 minute procedure done, even though it is life saving,” Lynette Brehm, Executive Director of the Big Bend Regional Hospital District, said. “As women, we sometimes put ourselves last and our health care last. So being able to bring the mammogram to the actual towns, to our area, has been really important.”
Earlier this year, the hospital district — an entity that oversees indigent care and other health issues in the region — hired a company called Assured Imaging after finding out that El Paso-based Desert Imaging was discontinuing its mobile mammograms program after providing the service in the Big Bend area for more than a decade.
Issues that arose from the new company’s recent dispatches to Presidio, Terlingua and Alpine included a high number of women with inconclusive results and providers not receiving radiology reports. The BBRHD submitted a formal complaint with the company upon receiving the feedback and received an official response around a month later with more data from the event.
Brehm told Marfa Public Radio this week that of the 193 patients served in May 24% received scores of zero, which indicate that an X-ray is inconclusive and further testing is required to rule out cancer. The nationally accepted rate of zero scores is between 5% to 12%, according to a BBRHD report on the mammograms investigation.
“That zero is non-conclusive, and that can be alarming for women, because they don't know ‘Well, what do I have? I have to go the extra step to get more imaging’,” Brehm said. “It's a normal part of the process, but it can be unsettling for a woman for sure.”
There are several reasons why a patient might receive inconclusive results from a breast cancer screening, according to the hospital district report. The person may have dense breast tissue, a family history of breast cancer or previous biopsies. Technical issues like machine malfunctions and images not being sharp enough can also occur.
Comparative images are often then sought out to see what’s normal and if anything has changed over time. Brehm said the hospital district was unable to get patient’s comparative images from Desert Imaging and that likely contributed to the unusually high amount of inconclusive tests.
Another major issue the investigation highlighted was that 69 women of the 193 who had a mammogram did not list a primary care provider (PCP), therefore there was nowhere to send their radiology reports. Patients do directly receive a letter explaining their results in simplistic terms.
“That was eye opening for us, because as the hospital district, we feel like we can help that for the next time around,” Brehm said.
Brehm said Assured Imaging’s higher management got involved in order to address the hospital district’s concerns and data the company provided helped staff understand exactly where things went wrong.
While there was no obligation — like a preexisting contract — to stick with the company, the hospital district’s board voted last month to bring the firm back for more mobile mammograms in January 2026. It costs the district less than $10,000 to bring out the mobile mammography unit for a week.
Brehm admitted there’s been “growing pains” with the program, but said she’s confident the district will be able to fine tune the process for future events.
“We are starting new with them and they don't necessarily know our community yet, so it's a little bit of learning about our community and some of the challenges that we have here, and us learning how they do business as well,” Brehm said.
The hospital district is still actively discussing the idea of purchasing a mammography machine for the Big Bend Regional Medical Center in Alpine, so that women could be screened anytime of year, Brehm said.
The district is meanwhile in the midst of a “Pink Out Big Bend” breast cancer awareness program, which includes story sharing events around the region for breast cancer survivors and other community members. At one of those events in Alpine on Monday, pink conchas and informational fliers were passed out as a small group discussed family medical histories.
“I feel like this is one of the first initiatives that the hospital district has done that has really brought these communities together,” Breham said. “If you go to Terlingua, Presidio, Marfa, Marathon, here in Alpine, you see the pink out signs, and people are talking about this issue.”
The hospital district is planning a next round of mobile mammogram screenings January 12 and 13 in Presidio, January 14 in Terlingua and January 15 and 16 in Alpine. The district will publicize how to sign up soon on its Facebook page.
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