New Study Reveals Disparities in 3D Mammography Screenings for Breast Cancer

A new retrospective study presented today at the San Antonio Breast Cancer Symposium demonstrated that the uptake of 3D mammography screening differed among women who belonged to different racial/ethnic groups, signaling an area of potential disparities in breast cancer screening. 

The use of digital breast tomosynthesis, also known as 3D mammography, for breast cancer screening is increasing, due to its lower rate of false-positive results and for its improved detection of cancer, especially among women with dense breasts.

The data from the study, co-led by Julia McGuinness, MD, and Katherine Crew, MD, members of the Herbert Irving Comprehensive Cancer Center (HICCC) at NewYork-Presbyterian/Columbia University Irving Medical Center, found that a significantly lower proportion of Hispanic and Black women who underwent screening over a two-year period received 3D mammograms.

“It is unclear if all women benefit from 3D mammography compared to 2D mammography (or just certain subgroups). However, the lower uptake of this novel technology among Hispanic and Black women could contribute to breast cancer disparities,” says Dr. McGuinness, first author of the study and assistant professor of medicine at Columbia University Vagelos College of Physicians and Surgeons (VP&S). 

Rather than having two views of the breast, 3D imaging provides a more detailed understanding of a woman’s breast tissue, providing images of the breasts in “slices.” This method is particularly beneficial in women who have dense breast tissue because having dense tissue makes it harder to detect breast cancers. 

Specific factors contributing to the difference in uptake of 3D mammograms among Hispanic and Black women are still  unknown. Further investigations, say the researchers, are needed to determine whether this difference is found at other medical centers and to identify specific factors driving the trend, such as potential access barriers linked to insurance coverage for 3D mammograms.

To evaluate sociodemographic and breast cancer risk factors associated with the uptake of 3D mammography among a diverse patient population, the study looked at a cohort of 5617 women who underwent screening mammography from 2020 to 2022 and who had information in the electronic health record for breast cancer risk calculation. Approximately 70% of women had at least one 3D mammography examination during the time period, but only 39.1% of Hispanic women and 67.9% of Black women received a 3D exam compared to a rate of 83.8% among white women.  

When the study took account analyses for age, breast cancer risk factors, and mammographic density, Hispanic women were 84% less likely and Black women 55% less likely to have received a 3D mammogram compared to white women.

“The findings from this retrospective study could inform future efforts to increase uptake of 3D mammography among diverse populations of women, particularly if ongoing prospective trials demonstrate benefit with 3D mammography compared to 2D mammography,” adds Dr. McGuinness.