WOMEN from racial and ethnic minority backgrounds are significantly less likely to receive same-day diagnostic breast imaging services, despite such services being available, according to new research.
A study also found that Black women are disproportionately less likely to undergo same-day biopsy procedures, even when available at their breast imaging facilities.
“This information may prompt radiologists to consider how their current models of care delivery may impact patients’ access and use of diagnostic breast imaging services and how it may lead to differences in care across patient subgroups,” the researchers reported.
Following an abnormal screening mammogram, additional imaging and potentially a biopsy are typically recommended. However, not all facilities that offer screening mammography provide diagnostic services, creating a barrier to swift diagnosis and treatment.
The availability of diagnostic services is influenced by socioeconomic factors linked to patients, their communities, and the broader healthcare system. Lawson and her team emphasised that understanding these disparities can guide efforts to reduce inequities in breast cancer care and outcomes.
The study examined data from 2010 to 2020 across 136 U.S. facilities, covering 1.1 million women aged 40 to 89 who had undergone a total of 3.5 million screening mammograms. The racial and ethnic distribution of the study population included White (68.3%), Black (12.7%), Asian (10.3%), Hispanic (6.5%), and other (2.2%).
While race and neighbourhood socioeconomic status were not significantly associated with the availability of on-site diagnostic services, racial disparities were evident in the likelihood of undergoing same-day diagnostics. Compared to White women, Asian, Hispanic, and Black women were significantly less likely to receive same-day imaging services after an abnormal screening mammogram.
Relative risk of undergoing same-day diagnostic services:
• Asian women: 0.74
• Hispanic women: 0.61
• Black women: 0.56
Furthermore, Black women were markedly less likely to receive same-day biopsies following abnormal diagnostic findings, with a relative risk of 0.46. Both Black and Asian women were also less likely to undergo digital breast tomosynthesis (DBT) diagnostic evaluations within 90 days of their screening exams.
Authors suggested that addressing these disparities would require a multi-level approach, including policy reforms in health insurance coverage to eliminate financial barriers. Facilities, she said, could also implement patient support initiatives, such as assigning dedicated staff to follow up on results and assist with scheduling necessary diagnostic procedures.
Future research, the team noted, will focus on improving understanding of access to diagnostic imaging and evaluating whether disparities exist in the quality of services provided.
“The quality of diagnostic imaging is important because failure to receive high-quality diagnostic imaging may lead to higher risk of missed cancers and delayed diagnoses,” she added.
Experts in the field have acknowledged the challenges imaging centres face in offering same-day services but urged them to increase availability and optimise workflows to improve patient access.
“This includes patient and referring provider education, access to necessary examination orders, appropriate scheduling templates, adequate staffing, and assistance with out-of-pocket costs and insurance coverage,” the authors wrote.
The findings underscore the ongoing need for systemic changes in breast cancer diagnostic services to ensure timely and equitable care for all women, regardless of racial or ethnic background.
Reference
Lawson MB et al. Disparities in standard-of-care, advanced, and same-day diagnostic services among patients with abnormal screening mammography. Radiology. 2025; DOI: 10.1148/radiol.241673.
