Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Cancer Epidemiol Biomarkers Prev. 2022 Jul 1;31(7):1324-1333. doi: 10.1158/1055-9965.EPI-21-1379.
We evaluated differences in diagnostic mammography performance based on women's race/ethnicity.
This cohort study included 267,868 diagnostic mammograms performed to evaluate screening mammogram findings at 98 facilities in the Breast Cancer Surveillance Consortium between 2005 and 2017. Mammogram assessments were recorded prospectively and breast cancers occurring within one year were ascertained. Performance statistics were calculated with 95% confidence intervals (CI) for each racial/ethnic group. Multivariable regression was used to control for personal characteristics and imaging facility.
Among non-Hispanic White (70%), non-Hispanic Black (13%), Asian/Pacific Islander (10%), and Hispanic (7%) women, the invasive cancer detection rate (iCDR, per 1,000 mammograms) and positive predictive value (PPV2) were highest among non-Hispanic White women (iCDR, 35.8; 95% CI, 35.0-36.7; PPV2, 27.8; 95% CI, 27.3-28.3) and lowest among Hispanic women (iCDR, 22.3; 95% CI, 20.2-24.6; PPV2, 19.4; 95% CI, 18.0-20.9). Short interval follow-up recommendations were most common among non-Hispanic Black women [(31.0%; 95% CI, 30.6%-31.5%) vs. other groups, range, 16.6%-23.6%]. False-positive biopsy recommendations were most common among Asian/Pacific Islander women [per 1,000 mammograms: 169.2; 95% CI, 164.8-173.7) vs. other groups, range, 126.5-136.1]. Some differences were explained by adjusting for receipt of diagnostic ultrasound or MRI for iCDR and imaging facility for short-interval follow-up. Other differences changed little after adjustment.
Diagnostic mammography performance varied across racial/ethnic groups. Addressing characteristics related to imaging facility and access, rather than personal characteristics, may help reduce some of these disparities.
Diagnostic mammography performance studies should include racially and ethnically diverse populations to provide an accurate view of the population-level effects.
我们评估了女性种族/族裔差异对诊断性乳房 X 光摄影术性能的影响。
本队列研究纳入了 2005 年至 2017 年间在乳腺癌监测联合会的 98 个设施中进行的 267868 例用于评估筛查性乳房 X 光摄影术结果的诊断性乳房 X 光摄影术。前瞻性地记录乳房 X 光摄影术评估结果，并确定一年内发生的乳腺癌。为每个种族/族裔群体计算了具有 95%置信区间（CI）的性能统计数据。多变量回归用于控制个人特征和成像设施。
在非西班牙裔白人（70%）、非西班牙裔黑人（13%）、亚洲/太平洋岛民（10%）和西班牙裔（7%）女性中，非西班牙裔白人女性的浸润性癌检出率（iCDR，每 1000 次乳房 X 光摄影术）和阳性预测值 2（PPV2）最高（iCDR，35.8；95%CI，35.0-36.7；PPV2，27.8；95%CI，27.3-28.3），而西班牙裔女性最低（iCDR，22.3；95%CI，20.2-24.6；PPV2，19.4；95%CI，18.0-20.9）。非西班牙裔黑人女性的短间隔随访建议最常见[（31.0%；95%CI，30.6%-31.5%）比其他组，范围，16.6%-23.6%]。亚洲/太平洋岛民女性的假阳性活检建议最常见[每 1000 次乳房 X 光摄影术：169.2；95%CI，164.8-173.7）比其他组，范围，126.5-136.1]。通过调整 iCDR 诊断性超声或 MRI 的接受情况以及短间隔随访的成像设施，解释了一些差异。调整后，其他差异变化不大。
诊断性乳房 X 光摄影术的性能在不同种族/族裔群体之间存在差异。解决与成像设施和获取相关的特征，而不是个人特征，可能有助于减少其中一些差异。
诊断性乳房 X 光摄影术性能研究应包括不同种族和民族的人群，以提供人群水平影响的准确视图。
