In April, Tiffany Gowen, MHA, director of the ACR Commission on Patient- and Family-Centered Care (PFCC), received an Honorary Fellowship from the Society of Breast Imaging (SBI) at their Annual Symposium at the Montréal Convention Centre in Quebec, Canada, for her work in advocating for access to proper screening practices and tools for patients all over the world. Gowen has spearheaded many efforts to support this cause, such as co-founding and leading the ACR Breast Cancer Screening Leaders Group and working tirelessly to promote and advance lung cancer screening, including several recent major initiatives in Puerto Rico. Gowen spoke with the Bulletin about her advocacy work in breast and lung cancer screening and what the fellowship means to her.
How did you get involved with the Breast Cancer Screening Leaders Group?
I originally started at the ACR as a temporary employee with the Quality and Safety (Q&S) Accreditation team. Then, former EVP for Q&S Pamela Wilcox, RN, MA, let me know that they had an administrative position open that I ended up applying for. Pam Wilcox is a pioneer when it comes to breast imaging. She helped create the Mammography Quality Standards Act. She and I started working very closely with Debra L. Monticciolo, MD, FACR, FSBI. We saw that a lot of the breast imagers were starting to retire. We know breast imaging has had controversial guidelines. We decided with Dr. Monticciolo, who was chairing the ACR Commission on Breast Imaging at the time, to create the Breast Cancer Screening Leaders Group, where about 10 seasoned faculty members would handpick 15 younger breast imagers (one of whom is now ACR CEO Dana H. Smetherman, MD, MBA, MPH, FACR). We created a 10-week course, which I ran. We had an in-person meeting, and we did media training so these members would know how to address the media and answer questions appropriately using ACR guidelines and resources. We did this for four cohorts. I ended up taking over as staff liaison for the Commission on Breast Imaging when Pam Wilcox retired, and I ran that Commission for about 15 years. The Screening Leaders Group is still extremely active, and a lot of the screening leaders are now leaders in radiology.
Talk to us about being named an Honorary Fellow Award by the SBI. How did you find out about your nomination?
It’s a funny story. I was lying on the couch with my kids because we all had COVID-19, and I saw a text from Mary S. Newell, MD, FACR. She said, “We have some exciting news for you. You’ve been named an SBI Honorary Fellow.” She told me, “I wanted to personally call you because I’ve worked with you for so many years and you’ve been such a part of my growth as a screening leader.” I was so shocked. I was beyond honored because so many of the prior honorees were my mentors, and to even be considered in that same realm blew me away.
As somebody who's been in this field for over 15 years, to grow up at the ACR and see all the people that I looked up to so much get the same award, it just makes you feel so special.
What does being named an Honorary Fellow mean to you and your career?
It’s huge. It's really the first big award that I’ve received in my career. As somebody who’s been in this field for over 15 years, to grow up at the ACR and see all the people that I looked up to so much get the same award, it just makes you feel so special. It just lets you see the work that you do matters, that people are taking notes and that the late-night calls, the Saturday calls, the Thanksgiving calls, they mean something.
How did your work in breast cancer screening spur your interest in lung cancer screening?
The opportunity to work on lung cancer screening was presented to me by EVP for Quality & Safety Mythreyi Chatfield, PhD, who I worked with after Pam retired. There was an opportunity to work with the ACR Lung Cancer Screening Steering Committee because lung cancer screening was still in its infancy. Guidelines were still new and the ACR wanted to take a bigger stance on lung cancer screening and develop more programming around it with more resources. I was given an opportunity to work with Debra S. Dyer, MD, FACR, to mold the Steering Committee and create a lot of wonderful resources. We started with 10 Steering Committee members, and we’re now up to 67.
You’ve recently been working with the Governor of Puerto Rico on lung cancer screening. What spurred you to take on this project and how is it going?
I am Puerto Rican. I went to high school there surfing the waves. I just love that island; I always say my heart is there.
There’s a high prevalence of lung cancer on the island because of smoking history or toxins inhaled. I saw that the American Cancer Society could not even pull data from the island because the lung cancer screening uptake was so incredibly low. I got in contact with the ACR chapter in Puerto Rico and I knew some doctors who were on my Steering Committee like Efren J. Flores, MD, FACR, who is an incredible advocate. I said, “We created National Lung Cancer Screening Day and I’ve worked with the Radiologic Society of Puerto Rico. Would you want to work with me to submit a proclamation to the Governor of Puerto Rico, Pedro Pierluisi?” The Radiological Society of Puerto Rico said “Yes, go ahead!” I submitted it and kept bothering them. Finally, they reviewed it, and because of the proclamation for National Lung Cancer Screening Day and Lung Cancer Awareness month, it started to spawn some interest on the island. The radiologists I worked with were on the news. They did amazing reports, podcasts, TV interviews and radio interviews. It sparked a lot of interest. I was recently down there again in April speaking. I started to connect with the cancer plan creators for the CDC in Puerto Rico and I asked if I could help them create a section for lung cancer screening for the island. I started to do outreach to all the universities and college campuses. We are creating chapters there to have college students go out and do advocacy for us. I mentored the college students and let them know that what we have at the ACR are resources that can help the screening centers. I’ve been pushing our ImPower Network. I’ve also been pushing ACR CT Accreditation and the ACR Lung Cancer Screening Center designation, because there’s only two on the entire island, so I’d really love to see that number go up.
How did this work lead to your leadership role with the PFCC?
When the ACR saw what I was able to do with Lung Cancer Screening Steering Committee, the opportunity arose to assume a leadership role with the PFCC. There has been a lot of want and need to increase the visibility of PFCC within the College. I’ve adapted a lot of the things that I did with the Steering Committee at a higher level with the PFCC and we’re continuing to evolve. We are hoping within the next year or two to become a revenue generating program for the College.
Reflecting on everything we’ve talked about today, what is your vision for the PFCC?
My vision for the PFCC is to get it into every aspect of the ACR and radiology. If someone’s getting a scan, it’s not because they’re okay. Radiologists have this pivotal role in a patient’s life — that their life is either going to go this way, or that way, and radiologists hold the answer. Taking that one step and talking to a patient about their exam or about a finding, being available to a patient to answer questions or even ease their mind about their imaging, makes all the difference. I would love to see radiologists take a bigger role in PFCC, because they have this opportunity. What I always say is that the one thing that AI does not have, and will never have, is a pulse, a warm hand to tell a patient, “I know this is hard,” or “I know you’re worried and you’re scared, but we’re here for you.” AI is not going to do that. AI won’t have a way to comfort patients and radiologists can do that.