Wellstar expands early breast cancer screenings efforts
More than 100 women in their 20s and 30s in Cobb County recently learned that they have an increased or high risk of developing breast cancer — news they received from early screening through Wellstar Health System.
The patients might not have had a family history of the disease — which could have delayed a potential diagnosis until 40, the standard screening age. But with breast cancer increasing among younger women, Wellstar decided to partner with a startup company specializing in breast cancer screening to help women ages 24 to 39 assess and reduce their risk.
Through a pilot partnership with Gabbi, Wellstar clinicians can now identify younger patients and recommend next steps. These may include follow-up testing and lifestyle changes, such as improving diet to reduce their chances of developing the disease.
“Historically, they tend to fall through the cracks,” said Dr. Safia Siddiqui, a Wellstar primary care physician who supervises the Gabbi clinicians screening patients through telehealth.
Breast cancer is the leading cause of cancer deaths in women ages 20 to 49 in the U.S., and women under 40 are nearly 40% more likely to die from breast cancer than older women, the Cancer Research Foundation recently reported.
Women typically aren’t screened for breast cancer until age 40, when the American Cancer Society recommends women begin yearly mammograms. For those with a high risk, the ACS advises having breast magnetic resonance imaging and a mammogram every year starting at age 30.
“Unfortunately, over 85% of breast cancer risk is sporadic in women who don’t have a family history,” Siddiqui said.
Wellstar is the first health system to pilot and implement Gabbi’s online technology platform, which uses artificial intelligence to evaluate younger patients’ risk for breast cancer. Wellstar patients can also schedule a telehealth session with a Gabbi clinician who can guide necessary care.
Earlier this year, Wellstar piloted Gabbi at its Cobb Medical Center and recently expanded it to its Kennestone Regional Medical Center and West Cobb Medical Center, Douglas, Spalding and West Cobb OB-GYN offices. More hospitals and primary care physician offices are expected to offer the program soon.
Women with a family history of breast cancer might forget to share that information with their doctor, or their doctor may have limited time and breast health specialization to carefully evaluate a patient’s risk, said Jaimie Clark, head of innovation and venture strategy with Catalyst, Wellstar’s venture capital company.
At last count, about 40 Wellstar providers referred nearly 1,660 women to the program for further evaluation. Of those, about 22% of the women took Gabbi’s online risk assessment and had a telehealth visit. More than a third of those patients — or 100 women — learned they had an increased or high risk of developing the disease, Wellstar reported.
How Gabbi works
Patients complete Gabbi’s online questionnaire about their lifestyle, personal health and family history. Siddiqui works with the Gabbi breast specialist, a nurse practitioner, to analyze the results using AI.
During a telehealth visit, the NP might ask follow-up questions for a full picture of the patient’s breast health. Depending on the results, the clinicians may recommend a personalized care plan including further screening through genetic testing, a mammogram, breast ultrasound or MRI. The clinicians also might refer patients to Wellstar’s breast health program, which includes a breast surgeon and oncologist.
A Gabbi care coordinator will then set up a schedule for how often the patient should be tested or have imaging and suggest lifestyle modifications to help them manage their risk.
Private insurance tends to cover virtual visits if Wellstar is the patient’s in-network provider, but applicable out-of-pocket costs depend on the insurance plan. For those who don’t have insurance, the initial visit costs $170 and follow-up visits costs $130, Gabbi reports.
As the program expands, Wellstar also hopes more women in underserved communities will be able to take advantage of the virtual platform. Clark explained that lower-income women in rural areas may not visit a doctor often to know they are at higher risk of breast cancer.
“We will talk to community health teams in our system about how they can expand access to Gabbi.”
Fight for attention
In 2020, Kaitlin Christine started Gabbi to eradicate late-stage breast cancer in honor of her mother, Lise Gabrielle. Despite annual mammograms, Gabrielle’s cancer went undetected and she died from a delayed diagnosis at 56.
“She had mammograms every year like she was supposed to, but it turned out because she didn’t know her risk and neither did her OB-GYN, that was not the right screening her,” Christine told The Atlanta Journal-Constitution, adding that she needed to have a breast MRI.
Soon after her mother died, a 22-year-old Christine found a lump in her breast. Despite her recent family history, her young age conflicted with the standard imaging guidelines for mammograms. As a result, she had to convince her OB-GYN and primary care doctor to screen her further for breast cancer, she said.
During preventive surgery to limit her risk at age 24, she, too, was diagnosed with breast cancer.
Christine, who later trained in hereditary cancer, founded Gabbi to prevent other women from being screened incorrectly or overlooked for preventive breast cancer screening.
“What I experienced is essentially what I have now tried to circumvent: that you can get direct access to a breast specialist. You don’t have to wait months, and it also relieves some work from the OB-GYN or primary care doctor who sees so many patients in a very short amount of time.”
Roni Robbins has been a journalist for 38 years. This is her second stint as a freelance reporter for the AJC. She also freelances for Medscape, where she was an editor. Her writing has appeared in WebMD, HuffPost, Forbes, the New York Daily News, BioPharma Dive, MNN, Adweek, Healthline and others. She’s also the author of the award-winning novel, “Hands of Gold: One Man’s Quest to Find the Silver Lining in Misfortune.”
