Transforming the Care for Women with Breast CancerBy Miriam Bello | Sat, 12/21/2019 - 10:00
Q: What is Alerta Rosa’s purpose and how does it work?
A: Alerta Rosa is a Doctors and Researchers in the Fight Against Breast Cancer (MILC) program with the mission to transform the care for women with breast cancer. This, unfortunately, is the most common form of cancer in Mexico and one of the biggest challenges we have in the country and in Latin America.
The program was created to address the issue of late diagnosis. Alerta Rosa helps women who suspect they have breast cancer by connecting them with specialized imaging centers equipped with digital mammography equipment, ultrasound equipment and radiologists who have an aggregated qualification in breast cancer diagnosis. We also introduce them to breast surgery specialists and we help them undergo a biopsy as soon as possible. We diagnose and refer patients to start treatment through IMSS, Seguro Popular and ISSSTE, as well as using medical insurance.
Studies show that patients take an average of 10 days to go to primary healthcare facilities. The problem comes when doctors take an average of five months to diagnose the problem after a biopsy and two months to begin treatment. This is a seven-month delay between early suspicion and treatment. Through Alerta Rosa, we have decreased this lag time significantly. Once a patient activates Alerta Rosa, diagnoses are delivered after 15 days and treatment begins in 35 days.
Q: How is Alerta Rosa being communicated among the female population?
A: We decided to launch a strong social media campaign targeting women with the help of NGOs in Nuevo Leon such as Cruz Rosa and Unidas Contigo. We also receive support from the TecSalud Foundation that has worked to spread the message and attend to some patients.
MILC has demonstrated this is an effective program in solving a long-standing problem in Mexico. We began this project with a website in cooperation with the Ministry of Health in Monterrey to test Alerta Rosa among the ministry’s female workforce. After getting good results, we decided to move forward and open the website to the general population. It is an innovative program, with a medical network involved in logistics and strategy that has not been implemented anywhere else in Mexico. Currently, we have a traffic-light patient prioritization system. Red-light patients have palpable tumors and outflow of blood from the nipple or BI-RAD 4 or 5 mammography results. Yellow-light patients have breast pain and BI-RAD 3 results. Asymptomatic patients are our third priority.
We also are automating our communication with patients. Initially, we did everything manually, including appointments with doctors and delivery of test results. In 2019, we developed a digital platform that will help us to automate the process. Through our webpage, patients will be able to program their appointments and can get their results very quickly. We are in the trial stage and we will launch the platform in January 2020. This will help us to care for a larger number of patients and add more allies to our initiative. This year we will also expand and have more allied medical personnel and imaging centers with the certifications we request.
We are based in Nuevo Leon but we would like to replicate the same model in other states. We have a department in charge of identifying both public and private centers that have the necessary technology. We connect them with patients and in turn they offer preferential rates. Our platform is also designed to redirect patients to centers near to their homes because we know distance is another barrier for treatment.
Q: What factors make a company worthy of a pink distinction?
A: We look for socially responsible companies that focus on the fight against breast cancer. Companies with a pink distinction organize a corporate check-up program that seeks to reduce breast cancer mortality through early detection. The program is well-organized and includes several benefits for women and the company. We offer companies a digital platform where women have access to informative videos. If it is a large company, we provide training to its health staff. We grant the distinction when 70 percent of women over 40 have undergone quality mammography. We organize an event for the company where we award it with a trophy and the distinction.
The pink distinction program has resulted in timely detection and therefore a decrease in mortality, better quality of life, reduced work absenteeism and fewer radical surgeries. The biggest impact we have had is breast cancer detection in women who had no idea about the disease.
The first company who believed in the program was Sisamex, which is part of the Nuevo Leon Automotive Cluster. The company even won the Human Development Prize for implementing this program. Today, we have 12 companies in the program.
Q: What new projects are you working on?
A: We are planning to launch EvaRisk in 4Q19. It is important for women to understand the risks of breast cancer and even though all women are susceptible to developing breast cancer, there is a group of women at greater risk because of their family history. There are prognosis models that can help us categorize patients who are at normal, moderate or high risk. EvaRisk will be a webpage where women will be able to download a format to fill in their family and personal history. We will then provide them a document with information regarding their risk level and the recommendations for timely detection. It is important to have this information because there are women who require mammography tests before the age of 40. Similarly, there are those who could benefit from a breast magnetic resonance in addition to the mammography and ultrasound, along with a semi-annual consultation and access to genetic testing.
Besides Alerta Rosa, which focuses on patients with symptoms, we are also trying to improve the breast radiology infrastructure in Mexico. We are among the countries with the fewest mammographies performed and most of these do not comply with all the requirements outlined by the Official Mexican Standard. Diagnostic and imaging technologies have evolved a great deal but most of the equipment in the country is antique.
Q: What are Alerta Rosa’s strategies regarding prevention?
A: Breast cancer cannot be prevented. There are recommendations to reduce the risk but it will never go to zero. We organize campaigns to promote a healthy lifestyle, to reduce alcohol consumption and to highlight the importance of lactating. But we mainly focus on the message of timely detection; we believe that if we detect cancer at an early stage, we can impact mortality. Unfortunately, 70 percent of women detect cancer when it is already in an advanced stage.
Q: How is technology going to transform medical attention in the long term?
A: If we do not implement the latest systems and technology, our impact in the health industry will be limited. We are certain that through the use of technology, Alerta Rosa is the only way to care for a larger number of women. At the same time, the nature of our platform allows us to get valuable input on improvements needed, changes in our processes and sources of delay.
Alerta Rosa is a team of health professionals and technology developers focused on breast cancer. It is supported by Doctors and Researchers in the Fight Against Breast Cancer (MILC), a civil association focused on improving diagnosis and quality of life of patients with breast cancer in Mexico.