Collaborative Advocacy and the Science of Breast Cancer Screening

Debra L. Monticciolo, MD, FACR, Chair, American College of Radiology® (ACR®) Screening Leadership Group and Communications, ACR Commission on Breast Imaging, contributed this piece.

A decade ago, the American College of Radiology supported creation of the ACR Screening Leadership Group. The SLG educates mid-career breast imagers on the science of breast cancer screening so they can better speak, write and think about screening from a scientific perspective. A breast imaging radiologist armed with data-driven and fact-based information is a better advocate against any number of false breast cancer screening claims levied in the press – and even in scientific publications. Our nine week by-invitation-only course, first given in 2015 and repeated in 2017 and 2019, created a group of dedicated screening advocates ready to take on this role.

This year, I was asked to speak to a multidisciplinary group in Brazil called the Women Engagement for Equity in Medicine, or WEEM. This group includes radiologists, medical oncologists, surgeons, and radiation oncologists. After my session, held in May, WEEM asked several pointed questions about the SLG.  It was clear that they were familiar with the SLG concept, probably by reading this paper, and asked if I were willing to mentor them. Their enthusiasm was unmistakable. 

I created a mini-course curriculum to suit this need. Several volunteers graciously agreed to lecture with me during the five-week, four webinar course which consisted of nine lecture presentations. My thanks to my  co-speakers for the course: Sharp Malak, MD, MPH, Jay Baker, MD, Debbie Bennett, MD, Bonnie Joe, MD, PhD, Toula Destounis, MD, Sally Friedewald, MD and Dr. Ivie de Paula. Thanks also to the WEEM organizers: Dr. Ivie de Paula, Dr. Linei Urban and Dr. Beatriz Maranhao. 

Our Brazilian colleagues indicated that our kick-off session included a member of the Brazilian parliament. The course was in-demand and was a terrific success. At the three-week mark, our WEEM colleagues informed us that the Brazilian government had voted to move the age of initiation of breast cancer screening to 40 from 50 years of age – a huge win for breast cancer screening advocacy. They were quite gracious in thanking us for helping them attain this goal. Whatever help we gave, we were glad to do it. 

Our program is proof that knowledge is power and that advocacy can be made stronger with great teamwork. We are thrilled with our success in Brazil. We look forward to additional collaborations with our colleagues there. They helped define the need and we supplied the knowledge and expertise to help them achieve their goals. It is a win for ACR, a win for WEEM, and a big win for the women of Brazil.