Do race and ethnicity impact the accuracy of diagnostic mammograms?
Across a number of diagnostic performance measures, researchers recently found that the outcomes of diagnostic mammograms—including accuracy—varies in different racial and ethnic groups.
An analysis of more than 250,000 diagnostic mammograms revealed that the number of invasive cancers detected per 1,000 exams was highest among non-Hispanic white women, at 35.8. In comparison, Asian/Pacific Islander women were found to have 31.6 cancers detected per 1,000 exams, followed by non-Hispanic Black women at 29.5; and Hispanic women at 22.3.
These figures were reported in Cancer Epidemiology, Biomarkers and Prevention—a journal of the America Association for Cancer Research—after experts tapped into the Breast Cancer Surveillance Consortium to investigate the correlation between patients’ race and ethnicity and cancer detection rates. A total of 267,868 diagnostic mammograms that were completed between 2005 and 2017 were included in the research, from which numerous conclusions were drawn.
Lead author of the study, Sarah J. Nyante, PhD, associate professor of radiology at the University of North Carolina School of Medicine, discussed the findings recently, explaining that there are many known disparities that have been found in previous studies, but that insight into diagnostic mammography processes is still lacking.
Nyante suggested that disparities present in the screening stage likely carry over into the diagnostic stage as well.
“Breast imaging is an important first step to being diagnosed and getting into the treatment pathway. It’s reasonable to think that differences at the beginning of care would affect later outcomes,” she said.
Additional insights the study provided are as follows:
Positive predictive values were greatest among non-Hispanic white women (27.8); followed by Asian/Pacific Islander (24.3); non-Hispanic Black (23.4); and Hispanic (19.4).
False-positive reports were most frequent in Asian/Pacific Islander women at 169.2, followed by 136.1 for Hispanics, 133.7 for Blacks, and 126.5 for whites.
False-negative reports occurred most often in Non-Hispanic Black women at a rate of 4.6 per 1,000 mammograms, followed by 4.0 for whites, 3.3 for Asian/Pacific Islanders, and 2.6 for Hispanics.
31% of non-Hispanic Black women required short interval follow-up recommendations compared to 22.1% of white women, 16.1% of Asian/Pacific Islander women, and 23.6% of Hispanic women.
Black women were more likely to be diagnosed with later stage, higher grade tumors.
Of interest, patient-level characteristics had no bearing on the performance statistics, which prompted the study authors to suggest that research at the facility level and with more diverse cohorts are needed to better understand the role of race and ethnicity in cancer diagnostics.
“Examining differences in diagnostic digital mammography performance and tumor characteristic outcomes by race and ethnicity may help us understand why disparities in cancer detection and quality of care persists for some demographic groups,” Nyante said.
View the detailed report here.
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.