A mammogram takes about 10 minutes. This Breast Cancer Awareness Month, I talk with Angie Lane, CEO of The Rose in Houston, about everything it takes to get women to those 10 minutes, and what happens after.

With its Pink Fleet of mobile mammography units, The Rose finds 75 percent of the breast cancers it detects at stage zero or 1A.

The Rose has spent 40 years taking down the barriers to breast cancer screening. Its five mobile units travel across 45 Texas counties and park at places like schools, where a woman can be screened in about 10 minutes.

We also get into what happens after the mammogram: what a callback does and doesn’t mean, and how The Rose’s patient navigators guide women through diagnosis, treatment, and the scary question of cost.

I share my own early-stage diagnosis, found on my first mammogram, and we talk about why your past mammograms matter every time you’re screened.

Chapters

[00:02:30] How two women started The Rose 40 years ago

[00:03:20] The Pink Fleet: mammography on wheels

[00:05:43] Healthcare deserts and insurance deserts

[00:07:35] Mammograms in the school parking lot

[00:09:00] Why 75 percent of cancers found are early stage

[00:12:00] Fear and radiation worries

[00:13:20] What happens after an abnormal mammogram

[00:15:00] Patient navigators and paying for care

[00:17:30] "I don't have time for cancer" and bad actors

[00:21:10] Empower Her Sponsorship

[00:22:50] Why your past mammograms matter

[00:24:37] What other communities can learn

[00:30:00] Closing: Get screened and support The Rose

Visit The Hairy Chin Substack blog for links and more information about this episode.

[00:00:00:04 - 00:01:22:17]

We are in October, 2026, which is Breast Cancer Awareness Month. And for me, any conversation around breast cancer is quite personal. I was diagnosed with the DCIS, Stage Zero Breast Cancer, at 40 years old from my very first mammogram. It was a scary diagnosis, but I was fortunate to have found it so early and given quite clear treatment options. Going through it opened the doors to my work in women's health advocacy. And I talk about my diagnosis often because I want women to know that screening saves lives. And for me, anything that makes screening easier for women is something I'm on board with. So when I heard about a pink fleet of five mobile mammography units in Texas, I knew I wanted to learn more. I'm honored to have my guests today, Angie Lane, the newly appointed CEO of The Rose in Houston, Texas. The Rose is a nonprofit breast health organization that has served women for 40 years, providing breast cancer screening, diagnostic services, and patient navigation. And as I mentioned, their screening is mobile, traveling over 45 counties in Texas to help women get their mammograms. This is a really powerful episode about the barriers that keep women from getting the health care they deserve and how organizations like The Rose are meeting these women where they need them most.

[00:01:23:21 - 00:31:57:22]

Welcome to the Harry Tin podcast. I'm your host, Spencer Moore, a Barcelona-based patient turned female health advocate. Women have been told for decades to advocate for their health. This is where we talk about how to actually do it. For more conversations on female health, subscribe to the Harry Chin sub-stack to join the conversation yourself. And of course, follow the show wherever you're listening. These small but mighty steps help make this work possible. Thanks for being here. Let's get started. (Music) Today, I am joined with Angie Lane. She is the new CEO of The Rose in Houston, Texas. I am really honored to speak with you, especially here in October in Breast Cancer Awareness Month. Welcome to the podcast, Angie. Thank you, Spencer. It's such an honor to be here, and particularly during Breast Cancer Awareness Month. Such a great reminder of how far we've come in the last 40 years. You mentioned The Rose. It started about 40 years ago, about the same time as Breast Cancer Awareness Month. Our founder, Dixie Melillo, and Dorothy Gibbons were working at Bay Shore Hospital, which is a hospital outside of Houston here in Texas. 40 years ago, Dr. Melillo was one of the only female surgeons in the area, and the other surgeons were sending her breast cancer patients. And during that time, she just saw these really tragic cases of late-stage breast cancer, and her and her colleague, Dorothy, said, "Oh my goodness, no more. We really have to do something about this, that early detection is possible, and that no woman should suffer." And out of that, they first brought the first mammography machine to their hospital 40 years ago. And today, as you said, it's grown into the incredible resource for our community that The Rose is. We have five mobile units. They think of these as recreational vehicles. They're 40 feet long. They each have names like Rosie and Eva and Hope and Lily and Misty, and personalities that match their names. They have the latest 3D mammography, an exam room. They have a technician, a provider, and a driver, and they travel out two to three hours through 45 counties in Texas to be able to take mammography to women, particularly in these communities that I would say are healthcare deserts that don't have the opportunity to have that screening. It's really amazing how much has changed in just understanding breast health and breast cancer. Prevention is becoming a really big piece of the puzzle. You know, the statistics for treatment of stage zero and 1A breast cancer is just staggering, and I am one of those statistics. I was found on my first mammogram. It was a DCIS, very early stage, and I was treated very successfully. And my understanding is that in your mobile mammography units, you find a lot of these cases of early stage breast cancer. I'm so glad that you had that experience and that you've been able to get back to life, pretty normal life, on a relatively easy, it's no easy journey to get through breast cancer for sure. Certainly the barrier, there are significant barriers for many women. We live in the heart of Houston. We have the largest medical facilities right here in Houston. That is an amazing resource for our community, but it's not accessible to everyone. And that's what I think is so amazing about the model of the Rose, is that, you know, one of the barriers is just receiving the testing. And there are so many women that don't have access to this testing, especially when we're talking about the United States, you know, it is a massive area. There are a lot of rural communities that don't have these large hospitals. I would love to talk about these barriers with you because the Rose really is very incredible at addressing all of that. So perhaps we can talk about the healthcare deserts and the medical deserts, and then we can go on because there are a lot of actual barriers that we can touch on here. Absolutely. Well, by healthcare desert, I really mean a community where services, healthcare services really aren't readily available, as I mentioned. A woman may live an hour or two or even three away from a breast imaging center or the technology and the technician for annual screening. And that's really just not realistic. I think women have busy lives, even if they have insurance, which we can come back to, the thought that they're going to take six hours round trip, take the day off to be able to go into the heart of Houston to get a screening, I don't think is realistic for most women. And so one of the, when you think about many counties in Southeast Texas, not only do they not have hospitals, but they don't have mammography or even X-ray machines. So a mammography is a low dose X-ray machine that is our best detection for breast cancer in the early stages. The Rose serves more than 45 counties. And in most of those counties, the technology just doesn't exist. An insurance desert is a little different. And so there may technically be healthcare nearby, like I mentioned in the Texas Medical Center, but Texas also has the largest uninsured population. And that's particularly true for women that are eligible or should be getting their mammogram each year. So you think about women from 40 to 60, largely past childbearing age, many of those women, we have about a million and two, 1.2 million women in Texas that don't have health insurance. And so that can be a significant barrier as well. And so when our mobile coaches, Eva, Rosie, Hope go out into these communities with the mammography machine, one of the things that's really unique about the Rose is that we see both insured and uninsured women. They get the same level of service. The technicians don't know a woman's insurance status or sponsorship status. Community support allows us to be able to add on what we call sponsored women, women who might not have that opportunity. And so a great example that I like to think about is that we might go in a rural county and pull up to a high school or a middle school. Teachers in particular don't have a lot of access to their schedule. They might not be able to take a day off because of the way that their schedule is. We're able to provide services to those women. A mammogram really only takes about 10 minutes. They can step away for just a few minutes and be able to get that mammogram right there in their parking lot in our mobile union. And at the same time, there might be the women that work in the lunchroom or the custodial staff. They may be hourly and not have insurance. And so we can also provide services. We can add on services for those women as well and see them all in a day. I think this is fantastic because you are bringing the testing to the women because as we mentioned earlier, there are so many barriers. And when we're talking about it, it's not just about where you live, but it's about can you get time off work? Can you get childcare? Can you afford the gas to even go to the hospital? You could be in a rural area. You may not be. And so the fact that it's like these coaches that do blood draws and you can donate blood and they park downstairs outside the office. I mean, the fact that this is a service offered to women, I think is just so needed. Once you see it and you see that it functions and it finds these early stage breast cancers, you think this is brilliant and it needs to be everywhere. I would love for you to talk about some of the statistics because, as I mentioned, I read that you have a very large percentage that you're finding early stage breast cancer of the women who are having these mammograms done. And so I'd love to hear a bit about that. I'd also love to talk about what happens after the mammogram because it's one thing to get the test, but the next is following up. And I'd love to hear about that. Well, we mentioned at the top that early detection is really critical and leads to better outcomes. And I appreciate you sharing your story about how that led to a better outcome for you and how women that, if you have to travel a full day, you don't have gas, we've talked about some of the barriers, that that really reduces the likelihood that they're going to be able to access that sort of screening. We have these five mobile units. They're out in our communities every day. They're screening dozens of women each day in every community. And sadly, breast cancer is detected about on average about once a week among the women that are screened. One of the things that's promising and I think talks about the impact of taking this healthcare out into the communities is that when it's found, it is most often found 75% of the cases were detecting cancer in stage zero or 1A. And that, as you mentioned, is really where it is most treatable, highly survivable. Many times radiation, depending on the situation, many times radiation, a leptectomy, something that's more narrow in treatment can really address that problem. Sometimes a woman might not even need chemotherapy. They're able to have less invasive treatment and to be able to really get back to their lives in a way that certainly if it wasn't detected that earlier, would be a more uphill challenge. Many of the women that are screened in our mobile units tell us that if not for the mobile unit, if it hadn't come into their community, they wouldn't have been screened. And certainly I know friends of my own that have that, you know, it's easy to delay to not put your health first as a woman. When you have set, you have kids, you have a job, you might be a caretaker, you have, you know, many things going on in your life, you know, you might delay a year, two, three between screenings and that really can make a significant difference in your health. Absolutely. And, you know, recently I had an interview with a woman and we were talking about the emotional barriers of mammograms because if you have a history of breast cancer in your family, perhaps your mother, your sister, you know, people you love, and then you're bringing a lot of emotions into that room with you. And so I think that the easiest this can be made for women the better because if she has an emotional barrier, perhaps she doesn't want to have her breasts touched by somebody and then she has to drive an hour. That's even more of a reason that she's not going to want to have this test done. So, you know, if it's downstairs and all of her other, you know, colleagues are getting them done that day, she thinks, well, maybe I'll just go ahead and get it done. Yeah, no, that's right. And, you know, I think you're absolutely right. And a lot of women are afraid that a mammography will hurt. And so the rows, our technicians are very sensitive and very sort of putting women first, putting them in the driver's seat, making sure they're as comfortable as possible. Something we hear all the time is that, you know, women are afraid it is a low dose x-ray and they're worried about being exposed to radiation. And so we can talk to women about those fears that it's really, it does not raise your risk for breast cancer or any type of cancer any more than flying in an airplane or going outside that that it's such a, there's no reason to be able to delay screening out of fear. And that really, again, it's your best defense. If we think about an average woman, her lifetime risk of breast cancer is about one in eight, one in nine. And really, you know, being able to take those steps to protect your health and to encourage those around you. When was the last time you were screened? What, you know, I care about you. I want you to take care of your health. I think supporting women in that way, as you mentioned, is critically important as well. Yes, yes, I agree. And I do think that it's very fortunate now with the internet and with social media, we really do have a lot more conversations, open conversations. You see your friends may be putting on their social media, "Oh, I just got from getting my mammogram." It was kind of like the "I voted" sticker. You know, when you see it, you're like, "Oh, I should go vote." And when you hear it, I do think that it does kind of build up and up in our brains and our minds to say, "Okay, you know what? I need to do that too." And I think that's a really positive thing to help with these preventative steps. One of the things you mentioned is sort of what happens next. And so a woman, we go out into the community. We work with tremendous community partners. And so we have community navigators out that live and work in these communities where we go. We might... At East Texas is a healthcare desert, for example. And so we have a community navigator who works in that community that has lots of local relationships that, you know, it's not necessarily... The Rose is a very trusted source, but we also have partners so women can learn about the opportunity for mammography from their own physician, from their church, from other places that they trust. And then the navigator helps fill the schedule, helps with the logistics. And then in the event that there is a need for follow-up, and so that's most common, that a woman might be sent, "We saw something that we really want to just do a little more screening. It doesn't mean that you have breast cancer." In most cases, additional screening does not lead to a breast cancer diagnosis, but it's just something that our radiologist wants to get closer look at. And so in that case, they... Right now, our dream is to be able to provide diagnostic services in these communities, more diagnostic services. But right now, we would work with them to help them get into one of our two centers in Houston. And so we have two breast centers of excellence, right, in the Houston area. We'll work with a woman with a gas card if she needs it, whatever, to help schedule an appointment that works for her to be able to have an ultrasound and then, if warranted, a biopsy to be able to complete that sort of journey, to be able to get a diagnosis. That community navigator is a cheerleader, is a support, a source of information for that woman through that process. We have patient navigators that tag along with our community navigators. Many women have, as they go in and they go through this sort of continuum, they get to the point where, perhaps sadly, that they need to sit with our doctor and talk about the finding of what's been found and what the next steps are. We have patient navigators that have been with us for dozens, a decade or more, that really have experience helping a woman process and being able to think about what's next. As I said, many women have family or friends that accompany them. And that's fantastic and great support system. Some women don't. And so having that as experienced in this situation is critical to our mission. And so when a woman hears, when a woman first hears, you have breast cancer, often the first thing she thinks of is not, "Am I going to survive, but how am I going to pay for it?" And so the patient navigators are there to help think about navigating into treatment. If a woman has insurance, we have lots of opportunities here in Texas through the Med Center, being able to navigate those systems and being able to direct into treatment. If she doesn't have insurance, we're able to help be able to fill out the paperwork for, perhaps, community assistance. We have hospitals that have philanthropic programs. We have state programs. And so it's a lot to navigate, particularly if English isn't your first language, to be able to really access that, be able to figure out what's next for you. And that's where our patient navigators step in and really hold her hand through that process. And not only through treatment, but being able to, as I said, being able to be responsive to her needs. If she needs to travel in, does she need gas cards? Does she need to connect with community partners around childcare? What are the barriers to be able to make sure that she gets the treatment that she needs? And that's really where we have patient navigators that help a woman through that process. Yeah, I think that's fantastic. Because yes, I do think that when you have family or friends that offer to a company, that's fantastic. But if their experience is not in navigating what a diagnosis looks like, what it looks like if you need to ask for assistance, if you need to look for a sponsorship or things like that. So I love that you have that option that's there and that can be utilized by all of the women. Because it really is important to really think about the next steps moving forward. It can help lessen the overwhelm. Because when you're told that something has come back on a mammogram, things tend to go blank. It's really hard to move forward in those next steps. Yeah, and there are women, I hear women that come in and they tell us, "Oh, I don't have time for cancer right now. After Christmas, I'll follow up." Or really think that as women, we tend to put ourselves behind some of our family or some of the other commitments. And so a navigator can really help also in some ways be an accountability partner and a cheerleader to say, really getting in within a month is really important. Reminding about the benefits of really addressing it early and how that can really get you back to life in a timely manner. It was surprising to me how many times that that can make a difference is just having someone that is really cheerleading and reminding you and emphasizing the importance of taking your own healthcare as a priority and what kind of impact that could have. And also, another thing that sort of surprised me, as you mentioned, I'm relatively new in this role, is that there are, a friend of mine would call them bad actors, that there are people that would prey on women, particularly women that might not have insurance, that might reach out to them and try to navigate them in ways that are not helpful. And so having patient navigators that are trained, that are trusted, that they have the community resources that are able to then follow up and we do follow up. They do follow up up to five years after diagnosis to check in and to make sure that they're, to see what sort of support and resources they need to be able to have a successful journey. That's fantastic. I haven't heard about these kind of bad actors of people coming in to help patient navigation, but that aren't really trusted. That's unfortunate to hear, but it does show how important your patient navigators are in building that trust with these women. Earlier you talked about kind of local partnerships and I'd love to kind of hear about the partnerships and the connections with these local communities because it really does sound to me like this takes a village. Absolutely. Well, we work with a number of organizations on quite a different level. We work with medical facilities and hospitals and physician referrals. So we certainly have, we have a unique model as we mentioned, as we see both women who are insured and then women who are sponsored. And so there are a couple of different pathways that people come to us and both are critically important and important to the sort of unique model that our founders created. We work in the community with a variety of partners. You think about schools, we mentioned the food bank, you think about local physicians. It really takes a village to be able to get the word out and to be able to meet women where they are, to be able to then direct them either to a mobile day or to one of our centers in Houston. And really, all of this is possible thanks to the philanthropic support we receive. And so we have generous partners that help us provide equipment. It might be a medical facility that helps us provide our mammography unit or our ultrasound. It could be a foundation, a corporate sponsor, an individual that helps us underwrite our mobile units. And then I mentioned about our revenue model that we, it's important part of our revenue model to be able to see insured women, but sometimes particularly with the declining reimbursement rates from health insurance and Medicare and Medicaid, sometimes those reimbursements don't even cover the cost of providing service to the insured woman. It's an important part of our revenue source, but we really rely on community support to be able to be there for all women and to be able to ensure that we provide the same level of service. Well, it's amazing. And I do understand that your sponsorship program is the Empower Her sponsorship program. Would you like to talk about that? Sure. So a woman comes to the Rose and they are, particularly if they meet certain eligibility requirements, they're eligible for sponsorship. And so that means that they can access a mammography, particularly if they don't have insurance and they have very limited resources, they're able to be sponsored through the Empower Her program. That comes through donations. We also receive, depending on the criteria, some state support that can help women be able to access not only mammography screening, but then if there is something that needs further detection, they might need an ultrasound or a biopsy. And so the Empower Her program can help sponsor women into those items. You can also help women that potentially have insurance, but that have very high deductibles that could be a barrier. And so their mammogram was covered, but then they go to get a biopsy or an ultrasound and they face several thousand dollars expense because they haven't met their deductible. And so those are, again, opportunities where we want to find solutions for women, either through our Empower Her program or much lower self-pay opportunities so that they can access that treatment. And as I mentioned, a really important part of our mission is not to say, "Okay, you have breast cancer, go forward, good luck to you," but really to make sure that there's a continuum of care, that women know that they have a resource to direct them through these steps and to feel confident about those steps and then to be able to lead to treatment with good outcomes. Now, I'm kind of curious because I know myself as a breast health educator, I do know that mammograms are incredibly helpful when they are comparative. So when you have a mammogram in the past, when you go for a new mammogram, it's really important to bring that information with you because it does change a lot of how the test is read. So I'm a bit curious about how your records work. When these women come to you and they come from their work and they come into the parking lot, how is that? Is that explained to women that it's helpful to have previous testing or do they take their test and then they can send them after? How does that work? That's an excellent question. So I mentioned before the Rose is a center for breast health excellent and we have systems and procedures and technology that's equivalent to any hospital, any world-class facility. And so we have a radiological information system and so we do store when women do come from us, we do store their medical records year over year. When the mobile program, we have long-term relationships and we often go to the same places year after year. So women can come back and their records are on file and they can be screened year after year. Another key component though is that many times women are coming to us for the first time through our mobile program. And so they may not have had a mammogram before and so we are then beginning that record for them and that we share our records in the same way that any of the major healthcare facilities do, we're able to transfer records back and forth very easily. I did not know that when I started screening with my mammography screening and I'm not sure that a lot of women really do understand the importance of keeping those records and then sharing them as they move forward. It's a huge part of the puzzle. Absolutely. It's critically important. I'd love to kind of, you know, you have the mobile units, you're reaching women, you are making this as easy as possible for them. This is an incredible model and like I said, once you see it, you think, "Oh my gosh, this needs to be everywhere." What do you think that the Rose can teach other communities outside of these 45 counties that you're serving? Well, the Rose has 40 years of experience and I mentioned it. It grew from two women saying, "This is enough and we want to do something about it," and started with one mammography machine and now operates two breast health centers and five mobile units. And so I think building something over time and being able to grow is something that I think that any community can start today and take action for. I think some of the things that we've learned and that we've talked about is how important it is to meet women where they are, taking mammography and taking those tools out to the communities. Right now, the Rose has, as I said, we have five, we have the largest pink fleet, we call it, in Texas and we take the mobile units out to the community. At some point, we'd like to have even sort of small scale spaces in some of these rural communities that allow us to have not just the mammography but an ultrasound and a biopsy and more and more constant presence in those communities is something we'd like to grow to. I think we mentioned before, trusted community partners is critically important. None of us do anything on our own and we need those partners, particularly around treatment and being able to make sure women access the care they need, but also to be able to support our women and to be able to connect with them and to build that trust. And so community partners are really important and the best work always happens in partnership. And I think the continuum of care is really important. Helping women navigate through the screening, through the diagnosis and through the treatment is a really critical component to think about if you want to build something to help women access in the same way. Building a sustainable financial model. And so I mentioned what's really sort of unique about the Rose and what these two legends created is that we see the revenue from insured women helps us add on sponsorship for uninsured women. And then we seek philanthropic support to help us with our technology, with our units to be able to build out. That is a unique model for some areas in healthcare that I think is really important, particularly as I mentioned, as we see that reimbursements are declining and that we see a growing need. There is so much demand for our services, particularly in these rural areas that our hope is to be able to expand your community. And so I think that's a really important part of the role that we're seeing in the future years. Yeah. You know, I was going to ask you, you've been now in this role for six months, as you said, it's kind of a new role for you. I'm curious in those six months, what have you seen to be the biggest challenge in this new role and this model and what the Rose is doing for the community? Yeah, thank you for asking. You know, I would say first the greatest strength is just the community of support and how far that we, the tremendous support we receive from the community and the tremendous impact that it has. I would say that it's a very expensive model, being able to keep five mobile units. Remember, these are recreational vehicles that were retrofitted to have highly sophisticated technology and exam room and to travel on bumpy roads. These machines need to be climate controlled. They're highly sensitive. And so taking them out on bumpy roads in traffic, you know, it's not unusual to be sideswiped in a 40 foot vehicle that might take off a window. Keeping these mobile units operational out in the community every day is an expensive proposition. And so I think that we are committed to it and it has tremendous impact, as I've mentioned, being able to detect cancer early for women who wouldn't otherwise have that screening. But I think that, you know, I think I don't think we'll ever move away from mobile, but it does, it is an expensive proposition and we would like to be able, as I said, to create a more constant presence in these communities. And I think that's a challenge that we're gonna rise to over the next couple of years because the demand for our services is increasing. Insurance can be, there are issues with women having rolling off insurance all the time. We really want to make sure that we're able to provide service and be there. No woman today should die of breast cancer because she can't access screening or treatment. The tools and the technology are there and we really, it's our mission and our drive to be able to respond to that need. Yeah, that's fantastic. I mean, I'm blown away having learned about this organization and all of the work that we do, you know, it's just, it's such a valiant effort to help these women because there are so many women now. The advocate I spoke about earlier, Rebecca Bloom, she wrote a book called "When Women Get Sick," which I cannot recommend enough reading. And she talks about how, you know, divorce is one of the top reasons why women lose their health insurance. And, you know, there are just all these statistics that really blow your mind when you think about these barriers of women getting healthcare and what this organization is doing to facilitate and make it easier for them, I think is just fantastic. I have absolutely loved this conversation with you and, you know, I would love to hear any closing thoughts that you might have. Well, Spencer, I would say thank you to you and I am so in awe of your leadership and advocacy for women's health and the change that you're making every day. And so thank you for that. On behalf of our community and our organization, it's really inspiring the work that you do. I would leave with a final note to remind everyone about Breast Cancer Awareness Month. This is the perfect time to get screened if you haven't. More women make appointments in October than any other month and it's a great reminder. But beyond that, to take action. And so ask the women in your life, when's the last time they were screened and encourage them. We talked about, you know, the barriers that could be there for them and that just a little bit of encouragement for their life. And as you think about Breast Cancer Awareness Month, taking action to support organizations like The Rose that are really on the front lines in the fight of breast cancer is very much appreciated. I love that, Angie. Thank you so much for your kind words and for wrapping up. Those are all very important pieces of information and I will have all of the information for anybody listening to learn more about The Rose in the show notes, in the blog, all of it. It should be very easily and I'm just, I'm so appreciative of your time. I know you're very busy and so I really appreciate the time that you've shared with us today. Thank you so much. Thank you, Spencer.

[00:31:59:01 - 00:32:17:16]

Thanks for sharing your time with me today. If something resonated with you, here's what you can do. Share this episode with someone who might need it. Leave a review so more women can find this work and subscribe to the Harry Chen Substack to join the conversation yourself. Life takes a village. Thanks for being a part of ours.