Time to Diagnostic Resolution in Mobile Mammography Versus Urban Hospital-Based Breast Cancer Screening

Area of Science:

• Radiology and Imaging
• Public Health
• Oncology

Background:

• Mobile mammography units (MMUs) enhance breast cancer screening access in underserved communities.
• Evaluating MMU performance against traditional hospital systems is essential for optimizing screening pathways.

Purpose of the Study:

• To assess factors influencing screening site choice, recall rates, and time to diagnostic resolution for breast cancer screening.
• To compare outcomes between MMU and hospital-based screening settings.

Main Methods:

• Retrospective analysis of screening mammograms from MMU and hospital settings over two-week periods in 2022-2023.
• Measured recall rates, time to diagnostic resolution (including imaging and biopsy), and sociodemographic factors.
• Utilized chi-square, ANOVA, Kruskal-Wallis, and Cox regression analyses.

Main Results:

• MMU patients were more likely to be Non-Hispanic Black, uninsured, and lack a primary care provider.
• MMU cohort exhibited higher recall rates (18.8% vs 9.9%) and significantly longer time to diagnostic resolution (median 28 vs 11 days).
• Uninsured patients had reduced likelihood of diagnostic resolution (HR 0.42), and MMU patients had higher rates of not returning for follow-up (18% vs 3.8%).

Conclusions:

• MMUs improve access but require enhanced strategies for timely and equitable follow-up of abnormal mammograms.
• Opportunities exist to improve patient navigation, social work support, and financial assistance for MMU patients.
• Addressing barriers to follow-up care is critical for ensuring the effectiveness of MMU-based breast cancer screening.