Women of color are less likely to receive prompt follow-up testing after abnormal mammogram results, a new study has found.
Minority women are less likely than white women to receive same-day advanced imaging or biopsy after an abnormal mammogram, even though they have similar access to those services, researchers reported.
Black women were 44 percent less likely than white patients to receive same-day follow-up, while Hispanic women were 39 percent less likely and Asian women 26 percent less likely.
This racial disparity is undoubtedly causing many women undue fear and anxiety, said lead researcher Dr. Marissa Lawson, an assistant professor of radiology at the University of Washington School of Medicine in Seattle.
“Getting a screening mammogram is an anxiety-inducing experience for a lot of people, and most patients I encounter want their results as soon as possible,” Lawson said in a news release.
“If you’re able to do a diagnostic workup on the same day, instead of making them wait to schedule a follow-up visit — which might create a headache with work or transportation — that’s better for the patient,” she continued.
Follow-up testing after an abnormal mammogram could involve a more intensive mammogram, a breast MRI or an ultrasound scan, according to the National Cancer Institute. If those tests confirm the abnormal results, then a biopsy is needed.
For the new study, researchers analyzed the records of more than 1.1 million women between 40 and 89 years of age who underwent screening mammography at 136 facilities across six U.S. states between 2010 and 2020.
The research team did not find major differences in the onsite availability of advanced imaging and biopsy services for women from different racial or economic backgrounds.
“It was surprising to find similar availability (of technologies) across racial and ethnic groups,” Lawson said. “But we still saw big differences in who was getting those same-day services.”
For example, researchers noted that patients who lived in the lowest-income neighborhoods were 58 percent less likely to receive same-day follow-up.
Black women also faced a lag in receiving a same-day biopsy if a follow-up scan confirmed abnormal mammogram findings, results show. They were 54 percent less likely to get a prompt biopsy.
Researchers noted that women living in rural areas were 51 percent more likely to receive same-day follow-up than urban dwellers.
“The finding that rural individuals receive more same-day services suggests that services may be targeted to patients with clear barriers such as long travel times,” the research team wrote.
The new study was published Feb. 18 in the journal Radiology.
Impact on Black Women
The disparities identified in the study have profound implications for Black women. Breast cancer mortality rates are significantly higher among Black women compared to white women, despite similar incidence rates. According to the American Cancer Society, Black women have a 41 percent higher death rate from breast cancer than white women. Delays in follow-up care, as highlighted in this study, likely contribute to this disparity.
Several factors may explain why Black women experience these delays. Systemic racism within healthcare, implicit bias among providers, and socioeconomic barriers such as lack of transportation or time off work can all contribute to disparities in access to timely care. Additionally, historical and ongoing experiences of medical mistreatment can lead to distrust of the healthcare system, potentially causing delays in seeking or adhering to recommended follow-up procedures.
The psychological impact of these delays is also significant. The extended period of uncertainty and anxiety can take a toll on mental health, further compounding the stress associated with potential cancer diagnoses. The findings underscore the urgent need for targeted interventions to address these disparities and ensure equitable access to timely breast cancer screening and diagnostic services for all women, particularly Black women.
More information
The National Cancer Institute has more about follow-up testing after an abnormal mammogram.
SOURCE: University of Washington, news release, Feb. 18, 2025