Black women were more likely to experience a delay to follow-up biopsy after abnormal findings on mammography, according to results of a prospective cohort study published in JAMA Oncology.

Early detection screening programs for breast cancer can improve outcomes, but delays of 90 days or longer between abnormal result and biopsy reduce the benefit from early screening. Previous studies have related patient-level factors with follow-up delays.

This study evaluated prospective data collected between 2009 and 2019 in the United States for 7 Breast Cancer Surveillance Consortium (BCSC) registries. Differences in time to biopsy after an abnormal mammogram were evaluated on the basis of ethnicity.

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The population comprised 45,186 women with 46,185 screening mammograms with abnormal results. Patients were median age 56 years, 65.1% were White, 13.5% were Black, 12.2% were Asian, and 6.6% were Hispanic.

One-third of abnormal mammograms were not resolved through biopsy or aspiration within 30 days (34.6%), 16.2% were not resolved within 60 days (16.2%), and 12.2% were not resolved within 90 days. The overall median time to biopsy was 23.3 days (IQR, 12.0-45.4 days).

In the fully adjusted model, compared with White women, Asian (adjusted relative risk [aRR], 1.25), Black (aRR, 1.24), and Hispanic (aRR, 1.18) women were at increased risk of no biopsy within 30 days. Similar results were observed at 60 days. At 90 days, Hispanic women were not associated with increased risk of no biopsy compared with White women, but other ethnicity groups remained at increased risk.

Stratified by ethnicity, the adjusted median time to biopsy was 22.7 days for White women, 25.8 days for Hispanic women, 26.7 days for Asian women, and 27.4 days for Black women.

This study was unable to account for structural racism, which may have biased results.

These data indicated that the delay to biopsy following an abnormal mammogram was the longest for Black women.

Disclosure: Multiple authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Lawson MB, Bissell MCS, Miglioretti DL, et al. Multilevel factors associated with time to biopsy after abnormal screening mammography results by race and ethnicity. JAMA Oncol. Published online June 23, 2022. doi:10.1001/jamaoncol.2022.1990