HOHENFELS, Germany -- Most people know that breast cancer is the most common cancer among women in the United States. It affects one out every eight women. They may also know that regular mammograms reduce breast cancer deaths by more than 30 percent. Yet nearly one-third of all eligible women do not get screenings.

With all this common knowledge, why don't women get regular breast exams and mammograms? The American Cancer Society did a survey of 677 women on this very issue. The reasons they cited included: it caused too much pain; they were too busy; and they felt embarrassed to have the test.

The Hohenfels Health Clinic had similar problems. Women would not get their mammograms done. Letters were sent, phone calls were made and referrals authorized, but no matter what they tried, less than 50 percent eligible women would get the important test done.

For the first time ever, the clinic decided preventive health care as a part of their Patient Centered Medical Home initiative was more important than excuses. Two nurse case managers and the NCOIC of the clinic came up with a plan.

"We decided to make a day of the event," said Nicole Pearson, Hohenfels nurse case manager. "One of the things women hate about getting a mammogram is you have to go alone, it's uncomfortable and boring. So we decided to make it a 'Ladies Day Out.' We contacted the Dr. Ulrich Neumaier, at the Castra Regina Center in Regensburg. Once they got the idea of where we were going, they took off with it."

The clinic arranged to have the Castra Regina Center Mammography section closed one day a month in order to see only American women. The CRC opened up a waiting area only for the American ladies and filled it full of pastries, coffee, water and American magazines in English. The ladies were also given packets with maps of the local area shopping facilities. The clinic offered an all-day shuttle to and from the CRC to downtown Regensburg; ladies could also go shopping at the Regensburg Mall after their appointment or go to lunch and take a later shuttle back to Hohenfels.

The clinic's goal was to make the experience more enjoyable. It can be very lonely and depressing to go to these appointments. It can also be degrading, sitting there exposed with a strangers waiting to get a very uncomfortable procedure done.

In order to make it more comfortable, the CRC offered women gowns to wear throughout the procedure. They also had two radiologists read each report in order to get a first and second opinion. If there was a finding, the patient was offered an immediate ultrasound and diagnosis.

"One thing I hate is when they find a lump or something," one Hohenfels patient said. "In the past, I had to drive all the way to Landstuhl, and I waited four hours for an ultrasound which never happened because the radiology check-in people forgot I was in the lobby and they all decided to go home early. Then they had the nerve to ask me to drive up another day! That would have been 16 hours of my own gas!"

If a patient needed an ultrasound, the CRC did it immediately in the same room as the mammogram. There was no waiting. If a biopsy was determined necessary, they were prepared to offer that the same day as well.

Thirteen lucky women participated in the first Hohenfels Mammogram Day and others have already signed up for the next day at the end of March.

"Thank you for setting this mammogram event up for us," a patient lauded. "The day was organized and very efficient. For being something that is not so much fun to do yearly, this day was made to feel like a spa day. I can't wait for the next one."

"I really enjoyed being driven and having an escort," another patient said. "It made my visit care free and less scary. My appointment went well, very quick and was comfortable,"