Race Associated with Diagnostic Delays in Women with Abnormal Breast Cancer Screening

New BCSC study finds that Black women are at higher risk of diagnostic delays after abnormal mammography screening compared to White women

Posted by Marissa Lawson at 8:00 AM on Jun 28, 2022


After abnormal mammography screening results, women should undergo timely diagnostic breast imaging and, if warranted, breast biopsy. Delays in diagnostic work-up for breast cancer greater than 30 days can lead to significant anxiety and delays greater than 90 days are associated with worse patient clinical outcomes. BCSC researchers performed a multi-level analysis to examine which individual-, neighborhood-, and health care-level factors were associated with differences in timely diagnostic resolution by race and ethnicity following abnormal screening. In a large national cohort of 45,186 women with a recommendation for biopsy after abnormal screening, relative to White women, Black women experienced 22% higher risk of no biopsy within 30 days and 20% higher risk of no biopsy within 90 days after abnormal screening. Of all the factors, adjusting for the screening facility attended by women accounted for nearly 30% of the excess risk of no biopsy within 90 days among Black women. Thus, our findings suggest that Black women are at higher risk of diagnostic delays after abnormal mammography screening compared to White women, and that there are structural racism and health care system-level barriers to timely breast cancer diagnosis.  Future targeted interventions are needed to close the disparities gap.

Lawson MB, Bissell MCS, Miglioretti DL, Eavey J, Chapman CH, Mandelblatt JS, Onega T, Henderson LM, Rauscher GH, Kerlikowske K, Sprague BL, Bowles EJA, Gard CC, Parsian S, Lee CI. Multilevel Factors Associated With Time to Biopsy After Abnormal Screening Mammography Results by Race and Ethnicity. JAMA Oncol. 2022 Jun 23. doi: 10.1001/jamaoncol.2022.1990. Epub ahead of print. PMID: 35737381. [Link]

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Posted by: Marissa Lawson