Access to Breast MRI Affects Vulnerable Populations

Sociodemographic factors, including geographic distribution of advanced imaging, may exacerbate disparities in breast cancer risk, according to a study published in the Journal of the American College of Radiology.

Researchers from New Hampshire, Washington, Massachusetts, New Mexico, North Carolina, and Pennsylvania, sought to determine if the amount of travel time needed to access breast MRI had an effect on breast cancer risk factors. Mammography is relatively geographically accessible, they wrote, but this is not always the case for breast MRI.

The researchers examined 821,683 mammograms and 3,687 breast MRIs obtained from the Breast Cancer Surveillance Consortium, performed between 2005 and 2012. They assessed the time to travel to the closest and actual facility used, and differences between the two. They also reviewed the women’s breast cancer risk factors and sociodemographic characteristics.[[{"type":"media","view_mode":"media_crop","fid":"47808","attributes":{"alt":"Breast MRI","class":"media-image media-image-right","id":"media_crop_4785541451059","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"5664","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 128px; width: 171px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"©RSNA 2015.","typeof":"foaf:Image"}}]]

The results showed that 76% of the screening mammographic examinations took place at the closest facility, while only 51.9% of screening MRIs were performed in the closest facility. The median differential travel time among women not using the closest facility for mammography was between eight and 25 minutes, with a mean of 14 minutes; travel time was between 11 and 40 minutes, mean 20 minutes, for breast MRI.

“Differential travel time for both imaging modalities did not vary notably by breast cancer risk factors but was significantly longer for nonurban residents,” the authors wrote. “For non-Hispanic black compared with non-Hispanic white women, the adjusted odds of traveling farther than the closest facility were 9 percent lower for mammography but more than two times higher for MRI,” they added.

The researchers concluded that although travel time did not add to breast cancer risk, geographic distribution of advanced imaging could exacerbate disparities among women in some vulnerable populations.