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The Role of Screening Mammography in Addressing Disparities in Breast Cancer Diagnosis, Treatment, and Outcomes

  • Breast Cancer Disparities (LA Newman, Section Editor)
  • Published:
Current Breast Cancer Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This report summarizes the history of screening mammography and its potential value in addressing breast cancer disparities by improving early detection of disease in minority women, particularly African Americans.

Recent Findings

The landmark screening mammography trials provide no substantive data regarding the efficacy of mammography in African American women. Contemporary studies are inconsistent with regard to patterns of mammography utilization in African American compared to White American women, but it appears that screening is underutilized in all adult American women. Recent data suggest that mammography may be particularly valuable in addressing breast cancer disparities through the early detection of triple-negative breast cancer, which is more prevalent among African American women.

Summary

This review indicates that screening mammography is a valuable tool in efforts to achieve breast health equity.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. • Ahmed AT, Welch BT, Brinjikji W, et al. Racial disparities in screening mammography in the United States: a systematic review and meta-analysis. J Am Coll Radiol. 2017;14(2):157–65 This meta-analysis provides robust data on mammography utilization in African American, White American, and Hispanic/Latina women.

    Article  PubMed  Google Scholar 

  2. Molina Y, Silva A, Rauscher GH. Racial/ethnic disparities in time to a breast cancer diagnosis: the mediating effects of health care facility factors. Med Care. 2015;53:872–8.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Chen L, Li CI. Racial disparities in breast cancer diagnosis and treatment by hormone receptor and HER2 status. Cancer Epidemiol Biomarkers Prev. 2015;24:1666–72.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Tao L, Gomez SL, Keegan TH, Kurian AW, Clarke CA. Breast cancer mortality in African-American and non-Hispanic white women by molecular subtype and stage at diagnosis: a population-based study. Cancer Epidemiol Biomarkers Prev. 2015;24:1039–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Ma H, Lu Y, Malone KE, Marchbanks PA, Deapen DM, Spirtas R, et al. Mortality risk of black women and white women with invasive breast cancer by hormone receptors, HER2, and p53 status. BMC Cancer. 2013;13:225.

    Article  PubMed  PubMed Central  Google Scholar 

  6. • Jewett PI, Gangnon RE, Elkin E, Hampton JM, et al. Geographic access to mammography facilities and frequency of mammography screening. Ann Epidemiol. 2018;28:65–71 This study demonstrates the association between geographic proximity to a mammography unit and the likelihood of utilizing screening mammography.

    Article  PubMed  Google Scholar 

  7. DeSantis CE, Fedewa SA, Goding Sauer A, Kramer JL, Smith RA, Jemal A. Breast cancer statistics, 2015: convergence of incidence rates between black and white women. CA: Cancer J Clin. 2016;66(1):31–42.

    Google Scholar 

  8. DeSantis CE, Ma J, Gaudet MM, et al. Breast cancer statistics, 2019. CA: Cancer J Clin. 2019;69(6):438–51.

    Google Scholar 

  9. Newman LA. Breast cancer disparities: socioeconomic factors versus biology. Ann Surg Oncol. 2017;24(10):2869–75.

    Article  PubMed  Google Scholar 

  10. • Gerend MA, Pai M. Social determinants of Black-White disparities in breast cancer mortality: a review. Cancer Epidemiol Biomarkers Prev. 2008;17(11) This study summarizes the social, economic, and cultural factors that account for breast cancer disparities.

  11. Goding Sauer A, Siegel RL, Jemal A, Fedewa SA. Current Prevalence of major cancer risk factors and screening test use in the United States: disparities by education and race/ethnicity. Cancer Epidemiol, Biomarkers Prev: Publ Am Assoc Cancer Res, Cospons Am Soc Prevent Oncol. 2019;28(4):629–42.

    Article  Google Scholar 

  12. Harmon BE, Little MA, Woekel ED, Ettienne R, Long CR, Wilkens LR, et al. Ethnic differences and predictors of colonoscopy, prostate-specific antigen, and mammography screening participation in the multiethnic cohort. Cancer Epidemiol. 2014;38(2):162–7.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Schueler KM, Chu PW, Smith-Bindman R. Factors associated with mammography utilization: a systematic quantitative review of the literature. J Womens health (Larchmt). 2008;17(9):1477–98.

    Article  Google Scholar 

  14. Alexandraki I, Mooradian AD. Barriers related to mammography use for breast cancer screening among minority women. J Natl Med Assoc. 2010;102:206–18.

    PubMed  Google Scholar 

  15. Chang SW, Kerlikowske K, Napoles-Springer A, Posner SF, Sickles EA, Perez Stable EJ. Racial differences in timeliness of follow-up after abnormal screening mammography. Cancer. 1996;78:1395–402.

    Article  CAS  PubMed  Google Scholar 

  16. Jones BA, Dailey A, Calvocoressi L, Reams K, Kasl SV, Lee C, et al. Inadequate follow-up of abnormal screening mammograms: findings from the race differences in screening mammography process study (United States). Cancer Cause Control. 2005;16:809–21.

    Article  Google Scholar 

  17. Elmore JG, Nakano CY, Linden HM, Reisch LM, Ayanian JZ, Larson EB. Racial inequities in the timing of breast cancer detection, diagnosis, and initiation of treatment. Med Care. 2005;42:141–8.

    Article  Google Scholar 

  18. Caplan LS, Helzlsouer KJ, Shapiro S, Wesley MN, Edwards BK. Reasons for delay in breast cancer diagnosis. Prev Med. 1996;25:218–24.

    Article  CAS  PubMed  Google Scholar 

  19. Ballard-Barbash R, Potosky AL, Harlan LC, Nayfield SG, Kessler LG. Factors associated with surgical and radiation therapy for early stage breast cancer in older women. J Natl Cancer Inst. 1996;88:716–26.

    Article  CAS  PubMed  Google Scholar 

  20. Riley GF, Potosky AL, Klabunde CN, Warren JL, Ballard-Barbash R. Stage at diagnosis and treatment patterns among older women with breast cancer: An HMO and fee-for-service comparison. JAMA. 1999;281:720–6.

    Article  CAS  PubMed  Google Scholar 

  21. Farrow DC, Hunt WC, Samet JM. Geographic variation in the treatment of localized breast cancer. N Engl J Med. 1992;326:1097–2101.

    Article  CAS  PubMed  Google Scholar 

  22. Mandelblatt JS, Kerner JF, Hadley J, Hwang YT, Eggert L, Johnson LE, et al. Variations in breast carcinoma treatment in older Medicare beneficiaries: is it black and white? Cancer. 2002;95:1401–14.

    Article  PubMed  Google Scholar 

  23. Griggs JJ, Sorbero ME, Stark AT, Heininger SE, Dick AW. Racial disparity in the dose and dose intensity of breast cancer adjuvant chemotherapy. Breast Cancer Res Treat. 2003;81:21–31.

    Article  CAS  PubMed  Google Scholar 

  24. Susan G. Komen. A Perfect Storm: Highlight Breast Cancer Disparities Among African-American Women, available at: https://ww5.komen.org/uploadedFiles/_Komen/Content/About_Us/Media_Center/Komen_Perspective/A_Perfect_Storm.pdf; accessed December 10, 2019.

  25. Pallok K, De Maio F, Ansell DA. Structural racism — a 60-year-old Black woman with breast cancer. N Engl J Med. 2019;380:16.

    Article  Google Scholar 

  26. Amirikia KC, Mills P, Bush J, Newman LA. Higher population-based incidence rates of triple-negative breast cancer among young African-American women : implications for breast cancer screening recommendations. Cancer. 2011;117(12):2747–53.

    Article  PubMed  Google Scholar 

  27. Lee JM, Abraham L, Lam DL, Buist DSM, Kerlikowske K, Miglioretti DL, et al. Cumulative risk distribution for interval invasive second breast cancers after negative surveillance mammography. J Clin Oncol. 2018;36(20):2070–7.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Newman LA, Reis-Filho JS, Morrow M, Carey LA, King TA. The 2014 Society of Surgical Oncology Susan G. Komen for the Cure Symposium: triple-negative breast cancer. Ann Surg Oncol. 2015;22(3):874–82.

    Article  PubMed  Google Scholar 

  29. Bellio G, Marion R, Giudici F, Kus S, Tonutti M, Zanconati F, et al. Interval breast cancer versus screen-detected cancer: comparison of clinicopathologic characteristics in a single-center analysis. Clin Breast Cancer. 2017;17:564–71.

    Article  PubMed  Google Scholar 

  30. Newman LA, Reis-Filho JS, Morrow M, Carey LA, King TA. The 2014 Society of Surgical Oncology Susan G. Komen for the Cure Symposium: triple-negative breast cancer. Ann Surg Oncol. 2015;22(3):874–82.

    Article  PubMed  Google Scholar 

  31. Bellio G, Marion R, Giudici F, Kus S, Tonutti M, Zanconati F, et al. Interval breast cancer versus screen-detected cancer: comparison of clinicopathologic characteristics in a single-center analysis. Clinical breast cancer. 2017;17:564–71.

    Article  PubMed  Google Scholar 

  32. Hayse B, Hooley RJ, Killelea BK, Horowitz NR, Chagpar AB, Lannin DR. Breast cancer biology varies by method of detection and may contribute to overdiagnosis. Surgery. 2016;160(2):454–62.

    Article  PubMed  Google Scholar 

  33. Welch HG, Prorok PC, O'Malley AJ, Kramer BS. Breast-cancer tumor size, overdiagnosis, and mammography screening effectiveness. N Engl J Med. 2016;375(15):1438–47.

    Article  PubMed  Google Scholar 

  34. Lai HW, Kuo SJ, Chen LS, Chi CW, Chen ST, Chang TW, et al. Prognostic significance of triple negative breast cancer at tumor size 1 cm and smaller. Eur J Surg Oncol: J Eur Soc Surg Oncol Bri Assoc Surg Oncol. 2011;37(1):18–24.

    Article  CAS  Google Scholar 

  35. Kim J, Lee S, Bae S, Choi MY, Lee J, Jung SP, et al. Comparison between screen-detected and symptomatic breast cancers according to molecular subtypes. Breast Cancer Res Treat. 2012;131(2):527–40.

    Article  PubMed  Google Scholar 

  36. Ho AY, Gupta G, King TA, Perez CA, Patil SM, Rogers KH, et al. Favorable prognosis in patients with T1a/T1bN0 triple-negative breast cancers treated with multimodality therapy. Cancer. 2012;118(20):4944–52.

    Article  PubMed  Google Scholar 

  37. Olszewski AJ, Migdady Y, Boolbol SK, Klein P, Boachie-Adjei K, Sakr BJ, et al. Effects of adjuvant chemotherapy in HER2-positive or triple-negative pT1ab breast cancers: a multi-institutional retrospective study. Breast Cancer Res Treat. 2013;138(1):215–23.

    Article  CAS  PubMed  Google Scholar 

  38. Vaz-Luis I, Ottesen RA, Hughes ME, Mamet R, Burstein HJ, Edge SB, et al. Outcomes by tumor subtype and treatment pattern in women with small, node-negative breast cancer: a multi-institutional study. J Clin Oncol. 2014;32(20):2142–50.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Colonna SV, Higgins AK, Alvarez J, Saville BR, Lawrence J, Abramson VG. Analysis of risk of recurrence by subtype in </= 1-cm breast tumors. Clin Breast Cancer. 2016;16(3):223–31.

    Article  PubMed  Google Scholar 

  40. O'Brien KM, Mooney T, Fitzpatrick P, Sharp L. Screening status, tumour subtype, and breast cancer survival: a national population-based analysis. Breast Cancer Res Treat. 2018;172:133–42.

    Article  PubMed  Google Scholar 

  41. Spalluto LB, Thomas D, Beard KR, et al. A community-academic partnership to reduce health care disparities in diagnostic imaging. J Am Coll Radiol. 2019;16(4PB):649–56.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Trivedi AN, Leyva B, Lee Y, Panagiotou OA, Dahabreh IJ. Elimination of cost sharing for screening mammography in Medicare Advantage Plans. N Engl J Med. 2018;378(3):262–9.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Iyengar NM, Zhou XK, Gucalp A, Morris PG, Howe LR, Giri DD, et al. Systemic correlates of white adipose tissue inflammation in early-stage breast cancer. Clin Cancer Res. 2016;22(9):2283–9.

    Article  CAS  PubMed  Google Scholar 

  44. Fink R, Shapiro S, Roester R. Impact of efforts to increase participation in repetitive screenings for early breast cancer detection. Am J Publ Health. 1972;62(3):328–36.

    Article  CAS  Google Scholar 

  45. Shapiro S. Evidence on screening for breast cancer from a randomized trial. Cancer. 1977;39(6 Suppl):2772–82.

    Article  CAS  PubMed  Google Scholar 

  46. Shapiro S, Venet W, Strax P, Venet L, Roeser R. Prospects for eliminating racial differences in breast cancer survival rates. Am J Publ Health. 1982;72(10):1142–5.

    Article  CAS  Google Scholar 

  47. Nystrom L, Rutqvist LE, Wall S, et al. Breast cancer screening with mammography: overview of Swedish randomised trials. Lancet. 1993;341(8851):973–8.

    Article  CAS  PubMed  Google Scholar 

  48. Alexander FE, Anderson TJ, Brown HK, Forrest APM, Hepburn W, Kirkpatrick AE, et al. 14 years of follow-up from the Edinburgh randomised trial of breast-cancer screening. Lancet. 1999;353(9168):1903–8.

    Article  CAS  PubMed  Google Scholar 

  49. Shaevitch D, Taghipour S, Miller AB, Montgomery N, Harvey B. Tumor size distribution of invasive breast cancers and the sensitivity of screening methods in the Canadian National Breast Screening Study. J Cancer Res Therapeutics. 2017;13(3):562–9.

    Google Scholar 

  50. Miller AB. Mammography screening guidelines for women 40 to 49 and over 65 years old. Ann Epidemiol. 1994;4(2):96–101.

    Article  CAS  PubMed  Google Scholar 

  51. Baines CJ, To T, Miller AB. Revised estimates of overdiagnosis from the Canadian National Breast Screening Study. Preventive Med. 2016;90:66–71.

    Article  Google Scholar 

  52. Miller AB, Wall C, Baines CJ, Sun P, To T, Narod SA. Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial. BMJ. 2014;348:g366.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Nystrom L, Bjurstam N, Jonsson H, Zackrisson S, Frisell J. Reduced breast cancer mortality after 20+ years of follow-up in the Swedish randomized controlled mammography trials in Malmo, Stockholm, and Goteborg. J Med Screen. 2017;24(1):34–42.

    Article  PubMed  Google Scholar 

  54. Moss SM, Wale C, Smith R, Evans A, Cuckle H, Duffy SW. Effect of mammographic screening from age 40 years on breast cancer mortality in the UK Age trial at 17 years' follow-up: a randomised controlled trial. Lancet Oncol. 2015;16(9):1123–32.

    Article  PubMed  Google Scholar 

  55. Tria TM. Breast cancer screening update. Am Fam Phys. 2013;87(4):274–8.

    Google Scholar 

  56. Oeffinger KC, Fontham ET, Etzioni R, Herzig A, Michaelson JS, Shih YC, et al. Breast Cancer screening for women at average risk: 2015 Guideline Update From the American Cancer Society. Jama. 2015;314(15):1599–614.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  57. Practice Bulletin Number 179: Breast cancer risk assessment and screening in average-risk women. Obstetrics Gynecol. 2017;130(1):e1–e16.

  58. Monticciolo DL, Newell MS, Moy L, Niell B, Monsees B, Sickles EA. Breast cancer screening in women at higher-than-average risk: recommendations from the ACR. J Am College Radiol: JACR. 2018;15(3 Pt A):408–14.

    Article  Google Scholar 

  59. American Society of Breast Surgeons Position Statement on Screening Mammography, available at: https://www.breastsurgeons.org/docs/statements/Position-Statement-on-Screening-Mammography.pdf; accessed January 3, 2020.

  60. Turashvili G, Brogi E, Morrow M, Dickler M, Norton L, Hudis C, et al. Breast carcinoma with 21-gene recurrence score lower than 18: rate of locoregional recurrence in a large series with clinical follow-up. BMC Cancer. 2018;18(1):42.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Force USPST. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Int Med. 2009;151(10):716–726, W-236.

    Article  Google Scholar 

  62. Siu AL. Force USPST. Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Int Med. 2016;164(4):279–96.

    Article  PubMed  Google Scholar 

  63. • Chen Y, Susick L, Davis MB, Bensenhaver JM, Burns J, Nathanson SD, et al. Screening mammography can reduce disparities by improving triple negative breast cancer early detection and outcome: comprehensive evaluation of African American and White American patients. JAMA Surg. 2020; This study demonstrates the effectiveness of screening mammography in improving triple-negative breast cancer survival rates through early detection of this aggressive phenotype.

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Authors and Affiliations

  1. Department of Radiology, Weill Cornell Medicine, New York, NY, USA

    Kimberly M. M. Isakov & Kemi Babagbemi

  2. Department of Surgery, International Center for the Study of Breast Cancer Subtypes, Weill Cornell Medicine, 420 East 70th Street, New York, NY, 10021, USA

    Lisa Newman

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  1. Kimberly M. M. Isakov
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Correspondence to Lisa Newman.

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Isakov, K.M.M., Newman, L. & Babagbemi, K. The Role of Screening Mammography in Addressing Disparities in Breast Cancer Diagnosis, Treatment, and Outcomes. Curr Breast Cancer Rep 13, 259–267 (2021). https://doi.org/10.1007/s12609-021-00427-x

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