A UC Davis Health researcher collaborated on a comprehensive sociodemographic study exposing stark health disparities in access to 3D mammography.

The study results published in JAMA Network Open show that Black women and Latinas, as well as less-educated and lower-income women, have not been able to obtain 3D mammography as easily as white, well-educated and higher-income women.

Diana Miglioretti The research team reviewed 2.3 million breast screening exams collected by the national Breast Cancer Surveillance Consortium from 92 imaging facilities across five states. That makes it the largest-ever study of U.S. access to digital breast tomosynthesis (DBT), commonly referred to as 3D mammography. The exams were performed on women ranging from 40 to 89 years of age between January 2011 and December 2017.

The 3D technology is more accurate than traditional digital mammography. It can detect more cancers and yields fewer false positives. The study showed that access to the breast screening technology has not been equitable, even though it was approved by the U.S. Food and Drug Administration a decade ago.

“Given the large research sample and our longitudinal data collection, we were able to evaluate use by minority and traditionally underserved populations,” said UC Davis Professor Diana Miglioretti, the senior author of the paper. “Unfortunately, we were not surprised to find that these traditionally underserved populations were less likely to attend facilities that offered 3D mammography, and even when they did, they were less likely to receive a 3D mammogram.”

3D mammography access isn’t the same for everyone

Asian woman having a mammogram

In 2011, only 3% of women in the study could access 3D mammography at the time of their breast cancer screening. By 2017, that figure had grown to 82%. Unfortunately, this improved availability was not experienced equally. When both 2D and 3D mammograms were available onsite at the time of breast cancer screening, DBT was obtained by:

• 37% of Black women vs. 43% of Asian American women, 44% of Hispanic women and 53% of white women.

• 41% of women with less than a high school education vs. 50% of women with a college degree.

• 44% of women living in ZIP codes with the lowest quartile of median household income vs. 51% of women living in ZIP codes with the highest quartile of median household income.