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William J. Gradishar, MD, FACP, FASCO


Performance of Diagnostic Mammography Seems to Vary Across Racial/Ethnic Groups

By: Emily Rhode
Posted: Monday, October 10, 2022

Recent study findings investigated disparities in the performance of diagnostic mammography among four different racial/ethnic groups. Researchers found that diagnostic accuracy was highest in non-Hispanic White women and lowest in Hispanic women. Sarah J. Nyante, PhD, of the University of North Carolina at Chapel Hill, and colleagues reported their findings in Cancer Epidemiology, Biomarkers & Prevention. In most cases, the variations in diagnostic workups after screening were not explained by women’s individual characteristics. Instead, the data suggest that factors associated with the imaging facilities may explain these differences, especially since the women in the study population had already undergone screening mammography.

In this study, the authors used the Breast Cancer Surveillance Consortium to identify data from 267,868 diagnostic mammograms performed for women at 98 imaging facilities in the United States. The cohort consisted of women who self-identified as Hispanic (7%), Asian/Pacific Islander (10%), non-Hispanic Black women (13%), or non-Hispanic White (70%).

The authors reported the highest invasive cancer detection rates (iCDR per 1,000 mammograms) and positive predictive values (PPV2) were found in non-Hispanic White women (iCDR = 35.8%; 95% confidence interval [CI] = 35.0%–36.7%; PPV2 = 27.8%; 95% CI = 27.3%–28.3%) and were lowest among Hispanic women (iCDR = 22.3%; 95% CI = 20.2%–24.6%; PPV2 = 19.4%; 95% CI = 18.0%–20.9%). Non-Hispanic Black women had the highest rate of short interval follow-up recommendations (31.0%; 95% CI = 30.6%–31.5%) versus other groups, whereas false-positive biopsy recommendations were highest among Asian/Pacific Islander women (per 1,000 mammograms: 169.2; 95% CI = 164.8–173.7) versus other groups.

Overall, the study showed that the imaging facility as well as the simultaneous use of breast ultrasound or MRI during the diagnostic process contributed most to the racial/ethnic disparities. “Diagnostic mammography performance studies should include racially and ethnically diverse populations to provide an accurate view of the population-level effects,” the researchers concluded.

Disclosure: For full disclosures of the study authors, visit

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