By Rachel Ross
(Updated April 2011)

Every woman knows the guidelines: Do a breast self-exam every month. Never ignore a lump. Get the recommended mammograms and see your doctor regularly. With breast cancer, early detection is the key to survival.

But how can you do a breast self-exam if your hands don’t work? How can you get a mammogram if the machine isn’t accessible? How can you see your doctor regularly if you don’t have transportation you can use?

Most women with disabilities have faced these difficulties, and some have found creative solutions. All too many others have had to compromise.

“When we talk with disabled women about their experience of getting mammograms,” says Margaret Nosek, executive director of the Center for Research on Women with Disabilities at Baylor College of Medicine in Houston, Texas, “all they talk about is how hard it is — the inaccessibility of the equipment, the unwillingness of the technicians to work with them and the perception that their physicians are less likely to recommend mammography.” Yet a CROWD National Study of Women with Physical Disabilities found that disabled women are at least as likely to get their scheduled mammograms as nondisabled women. So a key issue, Nosek says, is not compliance but the quality of the recorded image. She illustrates with her own experience:

“The only time I ever went,” she recalls, “they told me they could only examine 10 percent of my breast. It’s very difficult to position me where they can take a good image. So if I had to fill out a survey that asked if I’ve had a mammogram, I would say yes. But it was a totally ineffective mammogram.”

That’s not good enough, says Debra Shabas, former director of the Initiative for Women with Disabilities at New York University’s Hospital for Joint Diseases in New York City. “It’s important that both views be done and the entire breast imaged,” she says. “If it’s a well done mammogram, the accuracy should be much better than