A Comparative Analysis of Mobile versus Stationary Mammography Units: Performance and Outcomes in a Breast Cancer Screening Program

Daniele Ugo Tari,1 Davide Raffaele De Lucia,1 Rosalinda Santonastaso,2 Marika Santarsiere,1 Amedeo Blasotti3 1Department of Breast Imaging, District 12, Caserta Local Health Authority, Caserta (CE), 81100, Italy; 2Department of Economics, University of Campania “L. Vanvitelli”, Capua (CE), 81043, Italy; 3General Management, Caserta Local Health Authority, Caserta (CE), 81100, ItalyCorrespondence: Daniele Ugo Tari, Department of Breast Imaging, District 12, Caserta Local Health Authority, Viale Paul Harris 79, Caserta (CE), 81100, Italy, Email [email protected]: Breast cancer screening programs often encounter challenges related to high costs and limited accessibility, particularly in rural areas. Mobile mammography units (MMUs) have emerged as a potential solution to address these barriers. This study aimed to compare the outcomes of mammography screenings conducted in fixed units and MMUs, focusing on recall rates, follow-up adherence, and screen-detected breast cancer (BC) rates.Patients and Methods: This retrospective study analyzed data from 790 women aged 50– 69 years who underwent mammography screening between January and February 2023. Participants were divided into two groups: group A (525 women, screened at fixed units) and group B (265 women, screened at MMUs). Key metrics included recall rates, biopsy rates, screen-detected BC rates, and refusal rates for follow-up evaluations. Statistical comparisons were made between the two groups to assess differences in outcomes.Results: In group A (mean age 58.8 ± 5.7 years), the recall rate was 6.1%, with 32 recalls, 8 biopsies, and 7 confirmed BC cases, yielding a screen-detected BC rate of 1.33%. In group B (mean age 59.6 ± 5.8 years), the recall rate was higher at 10.6%, with 28 recalls, 5 biopsies, and 3 BC cases, resulting in a screen-detected BC rate of 1.13%. Notably, refusal rates for follow-up evaluations were significantly higher in group B (42.9%) compared to group A (9%).Conclusion: While MMUs improve accessibility to underserved areas, they face challenges such as higher refusal rates for follow-up evaluations. The comparable screen-detected BC rates between MMUs and fixed units underscore the potential of combining both approaches in breast cancer screening programs. These findings highlight the importance of awareness campaigns to improve follow-up adherence and suggest that future research should focus on cost-effectiveness and sociocultural factors to optimize breast cancer prevention strategies.Keywords: mobile unit, screening, digital breast tomosynthesis, telemedicine, mammography, breast density