Impact of a Same-Day Breast Biopsy Program on Disparities in Time to Biopsy

Dontchos, Brian N.; Narayan, Anand K.; Seidler, Matthew; Mercaldo, Sarah; Miles, Randy C.; Ebert, Ellen C.; Lehman, Constance D.

doi:10.1016/j.jacr.2019.05.011

Cited by 37 publications

(17 citation statements)

References 14 publications

(24 reference statements)

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“…The disparities do not end with diagnostic mammography-Black women have been shown to have a longer mean wait time (in days) between diagnostic mammogram and biopsy [90]. Dontchos et al demonstrated that implementation of same-day breast biopsy programs can help to close the gap in disparities related to race and insurance [91]. Unfortunately, many facilities do not have the capacity to provide such timely care.…”

Section: Access To Advanced Imaging and Interventionsmentioning

confidence: 99%

Health Care Disparities in Radiology—A Review of the Current Literature

DeBenedectis¹,

Spalluto²,

Americo³

et al. 2022

Journal of the American College of Radiology

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Introduction: Health care disparities exist in all medical specialties, including radiology. Raising awareness of established health care disparities is a critical component of radiology's efforts to mitigate disparities. Our primary objective is to perform a comprehensive review of the last 10 years of literature pertaining to disparities in radiology care. Our secondary objective is to raise awareness of disparities in radiology.Methods: We reviewed English-language medicine and health services literature from the past 10 years (2010-2020) for research that described disparities in any aspect of radiologic imaging using radiology search terms and key words for disparities in OVID. Relevant studies were identified with adherence to the guidelines set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results:The search yielded a total 1,890 articles. We reviewed the citations and abstracts with the initial search yielding 1,890 articles (without duplicates). Of these, 1,776 were excluded based on the criteria set forth in the methods. The remaining unique 114 articles were included for qualitative synthesis.Discussion: We hope this article increases awareness and inspires action to address disparities and encourages research that further investigates previously identified disparities and explores not-yet-identified disparities.

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Section: Access To Advanced Imaging and Interventionsmentioning

confidence: 99%

Health Care Disparities in Radiology—A Review of the Current Literature

DeBenedectis¹,

Spalluto²,

Americo³

et al. 2022

Journal of the American College of Radiology

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“…Details regarding the design and implementation of our same-day biopsy program have been previously described [17]. To summarize, before August 2017, patients recommended for breast biopsy on the day of diagnostic mammography and/or ultrasound appointments were routinely scheduled to undergo the procedure on a future date, although biopsies could also be offered on the same day sporadically on an ad hoc basis.…”

Section: Same-day Breast Biopsy Programmentioning

confidence: 99%

“…We investigated all patients with SMI compared with all patients without SMI, and the subgroup of patients <65 years of age with public payer (Medicaid or Medicare) insurance and SMI (SMI-PP) compared with those without SMI. Patients with more than 60 days between biopsy recommendation and completion were excluded, as with our prior study [17], because this time interval likely reflected rare and unique circumstances and preferences leading to abnormally long times to biopsy.…”

Section: Participantsmentioning

confidence: 99%

“…In 2017, our academic breast imaging program initiated a same-day breast biopsy program in which patients recommended for biopsy are routinely offered for the biopsy to be performed on the same day as the diagnostic imaging visit [17]. Before this intervention, same-day biopsies had been performed sporadically on an ad hoc basis, but there was not a clear and consistent process to support the use of same-day biopsies across our patient population.…”

Section: Introductionmentioning

confidence: 99%

“…Before this intervention, same-day biopsies had been performed sporadically on an ad hoc basis, but there was not a clear and consistent process to support the use of same-day biopsies across our patient population. Initial analysis of outcomes from the first 6 months of the same-day biopsy program showed that, for the general population, this program decreased time to biopsy and mitigated disparities in time to biopsy on the basis of race/ ethnicity [17].…”

Section: Introductionmentioning

confidence: 99%

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Impact of a Same-Day Breast Biopsy Program on Disparities in Time to Biopsy for Patients With Serious Mental Illness

Wang

Hwong

Mercaldo

et al. 2022

Journal of the American College of Radiology

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Purpose: The aim of this study was to investigate disparities in time between breast biopsy recommendation and completion and the impact of a same-day biopsy (SDB) program for patients with serious mental illness (SMI), with a focus on more vulnerable individuals with public payer insurance.Methods: In August 2017, the authors' academic breast imaging center started routinely offering needle biopsies on the day of recommendation. Primary outcomes were the proportion of biopsies performed as SDBs and days from biopsy recommendation to completion over a 2.5-year pre-versus postintervention period, comparing all patients with SMI versus those without, and public payer-insured patients <65 years of age with SMI (SMI-PP) versus without SMI (non-SMI-PP). Multivariable proportional odds and logistic regression models were fit to assess association of SMI status, age, race/ethnicity, language, and insurance with days to biopsy and SDB within each period.Results: There were 2,026 biopsies preintervention and 2,361 biopsies postintervention. Preintervention, 8.43% of patients with SMI (7 of 83) underwent SDB compared with 15.59% of those without SMI (303 of 1,943) (P ¼ .076), and 2.7% of the SMI-PP subgroup (1 of 37) underwent SDB compared with 15.88% of the non-SMI-PP subgroup (47 of 296) (P ¼ .031). Adjusted for age, race/ethnicity, and language, disparities persisted in odds for undergoing SDB (adjusted odds ratio, 0.13; 95% confidence interval, 0.02-0.92; P ¼ .04) and having longer days to biopsy (adjusted odds ratio, 2.35; 95% confidence interval, 1.26-4.37; P ¼ .01) for the SMI-PP subgroup compared with the non-SMI-PP subgroup in the preintervention period. There was no evidence of these disparities postintervention for the SMI-PP subgroup. SDB proportion increased from 15.3% (310 of 2,026) to 36.09% (852 of 2,361) (P < .001) across all patients.Conclusions: A same-day breast biopsy program mitigates disparities in time to biopsy for patients with SMI and helps improve breast cancer care equity for this vulnerable population.

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