Patterns of Breast Cancer Screening and Access to Care in a Safety-Net System

Area of Science:

• Oncology
• Public Health
• Radiology

Background:

• Screening mammography is crucial for reducing breast cancer mortality by enabling early detection.
• Barriers such as inconsistent guidelines and limited primary care access impede screening mammography uptake.
• This study examines screening mammography patterns before breast cancer diagnosis in a safety-net healthcare system.

Purpose of the Study:

• To characterize screening mammography uptake patterns among patients diagnosed with breast cancer within a safety-net system.
• To identify factors associated with delayed or absent screening mammography.
• To inform strategies for improving breast cancer screening in vulnerable populations.

Main Methods:

• Retrospective study of patients diagnosed with invasive breast cancer between 2018-2019 at Parkland Health.
• Categorization of patients based on screening mammography: never screened (no mammogram in 5 years), ever screened (2-5 years prior), and recently screened (within 2 years).

Main Results:

• Of 468 patients, 50.6% were never screened, 24.1% ever screened, and 25.2% recently screened.
• Nodal status, tumor size, and cancer stage significantly correlated with screening uptake behaviors (p<0.001).
• Patients with established primary care providers were more likely to be diagnosed with early-stage disease (p<0.001).

Conclusions:

• A significant proportion of breast cancer patients (50.6%) lacked recent screening mammography.
• The high incidence of diagnosis in the 40-49 age group (27.9%) reflects past guideline limitations.
• Enhancing primary care connections and shared decision-making can boost screening mammography uptake, particularly in underserved groups.