Transformative, Patient-Centric Care: Digital Screening Program Provides Equitable Access to Breast Cancer Risk...

Breast cancer screening disparities persist in the United States, underscoring the need for universal tools to provide equitable care. This study analyzes two years of data from 15 Midstate Radiology Associates (MRA) sites through Connecticut, where all women were offered a digital risk stratification platform. The platform is offered in five different languages and was designed to identify individuals at an elevated risk for breast cancer and determine eligibility for genetic testing based on national guidelines.

A retrospective analysis was conducted across MRA sites from 1/1/2023 to 12/31/2024 to evaluate patient demographics. Before mammograms, all patients were invited to the Ambry CARE Program to assess breast cancer risk using the Tyrer-Cuzick (v8.0) algorithm and determine eligibility for genetic testing based on NCCN® guidelines for hereditary cancers conditions. We analyzed patient ethnicity, age, and language preferences for those who completed the digital screening tool. High-risk patients, those eligible for genetic testing, and individuals who underwent testing-including those with positive mutations-were compared.

Between 1/1/2023 and 12/31/2024, 91,513 assessments were sent to patients via SMS, email, and kiosks, with each method opened over 95% of the time. 77,095 assessments were completed, achieving an 84.2% completion rate. The tool supported over 1,100 patients in languages like Spanish, Polish, Chinese, and Vietnamese. Patient ethnicity was recorded as: White (73%), Hispanic/Latino (11%), Black/African American (6%), Asian (4%), French Canadian/Cajun (3%), Ashkenazi Jewish (2%), and 1% each for other ethnicities. 52% of respondents were aged 51-70, and 8,025 women (10.4%) had a Tyrer-Cuzick score over 20%. Among women with elevated lifetime breast cancer risk: White (71%), Hispanic/Latino (7.2%), Black/African American (5%), Asian (1.8%), French Canadian/Cajun (3.4%), Ashkenazi Jewish (2.6%), and 9% for other ethnicities. 67% were aged 41-60. Of 20,063 women (26%) eligible for genetic testing based on NCCN® guidelines, 69.4% were White, 8.6% Hispanic/Latino, 4.6% Black/African American, 1.7% Asian, 3.2% French Canadian/Cajun, 3.6% Ashkenazi Jewish, and 8.9% other ethnicities. 52% were aged 51-70. 6,051 women chose genetic testing, with 451 (9%) receiving positive results. Age and ethnicity distributions were similar across these groups with increase in percentage of Latin/Hispanic opting for genetic testing.

The digital tool effectively stratified breast cancer risk across diverse patient population, promoting equitable screening and education through multilingual options and personalized support.