Black women imaged for breast cancer less frequently than white counterparts, with DBT often underused

Radiologists image Black women less frequently for breast cancer than their white counterparts, with digital breast tomosynthesis often underused, experts reported in a large study published Tuesday.

DBT coupled with digital mammography has become the specialty’s preferred method of screening for America’s most diagnosed form of cancer. Yet, a lower proportion of Black women’s screenings were performed using both modalities when compared to Caucasian female patients (44% versus 61%), based on an analysis of 385,503 cases.

This disparity occurred despite numbers in the same study sample showing that women across all races experienced lower recall rates when imaged with digital breast tomosynthesis, experts wrote in JACR.

“Racial differences in screening frequency and DBT utilization are likely rooted in social, economic, cultural and educational disparities,” first author Nila Alsheik, MD, a radiologist with the Advocate Caldwell Breast Center in Park Ridge, Illinois, and co-authors detailed Feb. 16. “Less frequent screening of Black women indicates a need for improved access and educational strategies to emphasize the importance of regular screening.”

While the specialty has made tremendous strides addressing breast cancer-related mortality over the last 15 years, numbers still lag among certain patient populations. Black women, for instance, are more likely to be diagnosed at an advanced stage, with breast cancer carrying one of the highest mortality disparities compared to white patients, Alsheik and co-authors noted.

Wanting to better understand some of these challenges, researchers retrospectively analyzed data from 63 U.S. breast imaging facilities, logged between 2015-2019. They discovered that non-white women were less likely to undergo more than one breast exam. Recall rates, meanwhile, were significantly higher for those with just a single mammogram, and lower for DBT among all study subjects.

The investigation did not attempt to understand the reasons behind these inequalities, which presents an avenue for further investigation, authors noted.

“Additional research is required to elucidate these causes. It is unlikely that women can entirely influence their screening modalities, and therefore, interventions at societal, facility and provider levels to ensure appropriate access to DBT are warranted,” the team concluded.

You can read the rest of the analysis in the Journal of the American College of Radiology here. Others contributing to the piece included RAD-AID, the Black Women’s Health Imperative, the Denver Health and Hospital Authority and several academic medical centers.