Mall of Mammography

Diana Watters

YOU PROBABLY already thought you could meet your every consumer desire out at the Mall of America. But had you considered a mammogram after your visit to Camp Snoopy? If the mall's corporate tenants have their way, you soon will. This Friday, National Mammography Day, 17 metro-area female mayors will walk the mall in an effort to persuade all women over 40 to get mammograms. Later that day, the Macy's and Estée Lauder Fashion Show will feature breast-cancer survivors modeling clothes and promoting mammograms. And later this month, Nordstrom is slated to open an in-store mammography clinic, its fifth in the nation, at the mall.

There are, it's worth noting, no analogous clinics for men at the megamall. Colonoscopies or digital rectal exams for prostate cancer are simply not as profitable as the multi-billion-dollar mammography industry. Years of marketing have successfully associated mammograms with women's achievements, even women's rights. And now, mammograms are associated with women's special preserve: the department store and the mall.

According to Bloomington Mayor Coral Houle, Friday's "Mayors' March for Mammography"seeks to bring attention to the Sage Clinic, a not-for-profit clinic at the mall that provides moderate-income women with pap smears, mammograms, and breast exams at no charge. Notes Annette Bar-Cohen of the Minnesota Department of Health, which funds the clinic, "The megamall has 40 million visitors per year from all socio-economic categories. There are very few places where there are such large concentrations of people." The clinic particularly aims to serve the many women who do not have adequate insurance to cover screening.

The Nordstrom clinic, in contrast, will screen only women with insurance or those who pay out of pocket. (Mammograms typically cost more than $80.) Nordstrom will gain no direct dollars from the facility, and it will provide the space free of charge to Consulting Radiologists, Ltd., a radiology chain with five other metro locations. But the department store stands to clean up on the arrangement in other ways. For one, it can promote itself as the store on the side of women in the great war against breast cancer. For another, the demographic of people who get mammograms matches the demographic of department-store shoppers: women age 35 and over. According to Clinic Supervisor Judy Johnson, many women are too busy to get mammograms, "but all women have time to shop."

Nordstrom and Consulting Radiologists will utilize several linked marketing strategies to prompt women to buy. The clinic will be operated on a walk-in basis; women need no appointment or doctor's referral. If the clinic is busy when a woman arrives, it will provide her with a pager and she can shop until beeped for her X-rays. Women who use their Nordstrom credit card will be charged less for their mammograms. Women may receive a promotional coupon for, as Johnson put it, "some free little item" in the store. In sum, she says, the mall setting will make mammography a "positive, upbeat experience."

For Nordstrom, perhaps the most profitable aspect of the mammography clinic is that it promises to increase sales of breast-cancer paraphernalia. The clinic will be located in the store's Intimate Apparel department, where women can buy prostheses (with price tags from $200 to $440), bras, and other specially-tailored products. Women whose results indicate cancer will also receive written information about Nordstrom's extensive range of products for women with the disease.

What they will probably not receive is information about the continuing scientific debate over whether mammography is appropriate or effective for women in their 40s. The National Cancer Institute recommends that all women over 40 get X-rayed each year. But a National Institutes of Health panel this February concluded that the evidence was inconclusive as to whether such screenings produced any benefit. It urged women to weigh the risks and adverse effects of mammography--such as false positives, radiation problems, and overtreatment--and make their own decisions.

Nordstrom's Johnson, for her part, sees nothing to decide. "Mammography has been proven effective for women in their 40s," she claims. "And any woman can have a mammogram at the Mall of America. That's what's so wonderful."

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