Outreach for Earlier Screenings (2008)

Sheryl Gabram and cancer patient

Like more than 90% of the women who come to the Avon Breast Center at Grady Hospital, Aisha Johnson was by herself when she first heard the diagnosis.

No family members, no friends, no one to hold her hand. Busy raising two grandchildren, she had been reluctant to get a mammogram in the first place, having always heard it could cause cancer, no matter what the doctors told you, and now a doctor was talking about surgery and other treatments like radiation. The doctor said curable. Aisha heard only cancer.

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"That is the moment when I always ask patients if they would like to talk with one of our ladies in pink," says Sheryl Gabram (pictured at right), the Emory Winship Cancer Institute surgical oncologist who directs the Avon center at Grady. The pink-jacketed women are breast cancer survivors who have been through intensive training at the center and come from the same community as most of the patients.

A pink lady was assigned to meet with Aisha, making sure that she understood what the doctors were saying and that she didn’t miss appointments.

The pink lady/patient navigator program is part of an outreach initiative established several years ago and supported with private funding, including more than $2 million from Avon. Participants have made more than 3,000 presentations at health fairs, church gatherings, and other events, teaching the importance of early detection. Most of the 60,000 local women reached so far are African Americans, whose higher risk of death from breast cancer is attributed in large part to a more advanced stage of disease at the time of diagnosis.

Earlier this year, Gabram and her colleagues reported on the impact of the program from 2001 to 2004 when it had reached more than 10,000 participants. At the beginning of the study, 16.8% of women diagnosed at the center had stage IV invasive tumors. Three years later, that number had dropped almost by half, to 9.4%, while the proportion of those diagnosed with highly curable stage 0 tumors had doubled from 12.4% to 25%. One of those women was Aisha.

The doctor said curable. All she heard was cancer.