Same-Day Mammogram Readings Reduce Disparities and Speed Diagnoses

Immediately reading screening mammograms during the COVID-19 pandemic promises a new and improved paradigm that reduces care disparities, while increasing the speed of diagnostic workup. That’s according to a new article in the American Journal of Roentgenology (AJR) from the American Roentgen Ray Society (ARRS).

“The immediate-read screening mammography program reduced prior racial and ethnic disparities in same-day diagnostic imaging after abnormal screening mammograms,” wrote first author Brian N. Dontchos, MD, of Massachusetts General Hospital and Harvard Medical School.

In May 2020, Dontchos et al. implemented a program where a dedicated breast imaging radiologist interpreted all screening mammograms in real-time, with patients receiving their results before being discharged. A separate radiologist made efforts to perform any recommended diagnostic imaging during the same visit. The team then retrospectively identified screening mammograms performed from June 1, 2019 to October 31, 2019 (pre-implementation; 8,222 examinations) or June 1, 2020 to October 31, 2020 (post-implementation; 7,235 examinations). 521 and 359 patients had abnormal screening examinations, respectively.

Before implementing this immediate-read screening mammography program, patients with races other than White had lower odds than White patients of having same-day diagnostic imaging after abnormal screening examinations (adjusted odds ratio [OR]: 0.30; 95% confidence interval [CI]: 0.10, 0.86; p=.03). After implementation, these odds were not significantly different (OR: 0.92; 95% CI: 0.50, 1.71; p=.80).

Responding to the Society of Breast Imaging’s recommendation to reduce patient hospital visits during COVID-19, “we believe the practice is sustainable and not limited to only a transient period of lower-than-normal screening volumes,” noted the authors of the AJR article, titled Disparities in Same-Day Diagnostic Imaging in Breast Cancer Screening: Impact of an Immediate-Read Screening Mammography Program Implemented During the COVID-19 Pandemic.