Racial Disparities in Breast Imaging Wait Times Before and After the Implementation of a Same-Day Biopsy Program

Abstract

Objective: To examine time from screening to diagnostic workup, biopsy, and surgery for non-Hispanic White (NHW) and Black women following implementation of a same-day biopsy program. Methods: All NHW and Black women with BI-RADS category 0 screening mammogram at Duke University Hospital were identified between August 1, 2020, and August 1, 2021. Patient characteristics were recorded. Time between screening mammogram, diagnostic workup, breast biopsy, surgical consultation, and surgery were recorded. Comparisons were made between NHW and Black women using a multivariable regression model. Diagnostic imaging to biopsy time interval was compared to historical averages before same-day biopsy implementation. Results: There were 2156 women: 69.9% NHW (1508/2156) and 30.1% Black (648/2156). Mean ± standard deviation time from screening to diagnostic imaging overall was 13.5±32.5 days but longer for Black (18.0±48.3 days) than for NHW women (11.5±22.2 days) (P<0.001). The mean time from diagnostic mammogram to biopsy was 5.9±18.9 days, longer for Black (9.0±27.9 days) than for NHW women (4.4±11.8 days) (P=0.017). The same-day biopsy program shortened the time from diagnostic imaging to biopsy overall (12.5±12.4 days vs 5.9±18.9 days; P<0.001), with a significant reduction for NHW women (12.4±11.7 days vs 4.4±11.8 days) (P<0.001) but not Black women (11.5±9.9 days vs 9.0±27.9 days) (P=0.527). Conclusion: Disparities exist along the breast imaging pathway. A same-day biopsy program benefited NHW women more than Black women.