Research presented at this year’s annual meeting of the Radiological Society of North America shows the possible impact of social determinants of health (SDOH) on follow-up appointments for breast cancer. The findings demonstrate a possible link between risk for undiagnosed breast cancer and length of lapse in follow-up appointment.
“Diagnosing breast cancer at an early stage is very important for survival,” said Aaron Afran, a third-year medical student at Boston University School of Medicine (BUSM), in a statement. “Concerning mammography findings lead to the need for additional imaging, such as diagnostic mammography and ultrasound, and there can be a lapse in time between imaging appointments.”
Two groups of women who had breast imaging done at Bostom Medical Center (BMC) between January 2015 and December 2018 had their medical records retrospectively reviewed:
- Group 1 had 4959 women. They had a screening mammography and subsequently were recommended for diagnostic imaging. Their BI-RADS score was 0, the mean age was 59.1 years, and a majority (56.2%) were Black.
- Group 2 had 3028 women. They had diagnostic breast imaging and subsequently were recommended for biopsy. Their BI-RADS score was 4 or 5, the mean age was 60.9 years, and most (57.5%) were Black, as well.
For diagnostic imaging to biopsy, the longest lapses were seen with food (P < .001) and housing insecurity (P < .001), whereas having at least 1 SDOH (P < .001) or transportation issues (P = .0016) was linked with shorter lapses. Between screening mammography and diagnostic imaging, housing and food again exerted the most influence at extending the lapse, at P = .08 and P = .1405, respectively.
All of the women completed the BMC’s THRIVE screening tool, which addresses issues with education, employment, food, affording medications, housing, transportation, utilities, and caregiving. Close to one-third of the patients in both groups (group 1, 30.7%; group 2, 26.9%) had this complete data in their records, which covered from October 2017 to December 2018.
Afran posited that food and housing insecurity are simply more important priorities than imaging appointments among the patients studied.
“To best serve our patient population at a safety-net hospital, we must think creatively about the social factors that are preventing our patients from receiving the best care,” concluded Michael D. Fishman, MD, section chief of breast imaging at Boston Medical Center and the study’s senior author. “Our findings indicate longer lapses between diagnostic imaging and biopsy for patients with unmet social needs, which begs the question: are unmet social needs associated with some amount of breast cancer mortality that could have been prevented?”
Previous research mirrors their findings, reported Afran, in that the issue of later breast cancer stage at diagnosis has been shown to be influenced by poverty, lack of education, and social isolation.
Suggested areas of future study include analyzing the effects of these findings on survival and those of specific interventions.
Reference
Afran A, Donghoon S, LeBedis C, Fishman MDC. The impact of social determinants of health on breast imaging utilization. Presented at: RSNA 2020; November 29-December 5, 2020. https://press.rsna.org/pressrelease/2020_resources/2227/video_4.mp4
Social Determinants of Health May Influence Undiagnosed Breast Cancer Risk
Research presented at this year’s annual meeting of the Radiological Society of North America shows the possible impact of food or housing insecurity on follow-up appointments for breast cancer.
Research presented at this year’s annual meeting of the Radiological Society of North America shows the possible impact of social determinants of health (SDOH) on follow-up appointments for breast cancer. The findings demonstrate a possible link between risk for undiagnosed breast cancer and length of lapse in follow-up appointment.
“Diagnosing breast cancer at an early stage is very important for survival,” said Aaron Afran, a third-year medical student at Boston University School of Medicine (BUSM), in a statement. “Concerning mammography findings lead to the need for additional imaging, such as diagnostic mammography and ultrasound, and there can be a lapse in time between imaging appointments.”
Two groups of women who had breast imaging done at Bostom Medical Center (BMC) between January 2015 and December 2018 had their medical records retrospectively reviewed:
For diagnostic imaging to biopsy, the longest lapses were seen with food (P < .001) and housing insecurity (P < .001), whereas having at least 1 SDOH (P < .001) or transportation issues (P = .0016) was linked with shorter lapses. Between screening mammography and diagnostic imaging, housing and food again exerted the most influence at extending the lapse, at P = .08 and P = .1405, respectively.
All of the women completed the BMC’s THRIVE screening tool, which addresses issues with education, employment, food, affording medications, housing, transportation, utilities, and caregiving. Close to one-third of the patients in both groups (group 1, 30.7%; group 2, 26.9%) had this complete data in their records, which covered from October 2017 to December 2018.
Afran posited that food and housing insecurity are simply more important priorities than imaging appointments among the patients studied.
“To best serve our patient population at a safety-net hospital, we must think creatively about the social factors that are preventing our patients from receiving the best care,” concluded Michael D. Fishman, MD, section chief of breast imaging at Boston Medical Center and the study’s senior author. “Our findings indicate longer lapses between diagnostic imaging and biopsy for patients with unmet social needs, which begs the question: are unmet social needs associated with some amount of breast cancer mortality that could have been prevented?”
Previous research mirrors their findings, reported Afran, in that the issue of later breast cancer stage at diagnosis has been shown to be influenced by poverty, lack of education, and social isolation.
Suggested areas of future study include analyzing the effects of these findings on survival and those of specific interventions.
Reference
Afran A, Donghoon S, LeBedis C, Fishman MDC. The impact of social determinants of health on breast imaging utilization. Presented at: RSNA 2020; November 29-December 5, 2020. https://press.rsna.org/pressrelease/2020_resources/2227/video_4.mp4
Disparities in Multiple Myeloma Distress Screenings May Point to Care Gaps
March 20th 2025Patients who did not complete a distress screener were also less likely to receive autologous stem cell transplants.
Read More
Telemedicine’s Evolution and Expanding Access to Obesity, Specialty Care
February 11th 2025George Jones of UpScript Health discusses telemedicine's evolution from basic e-prescribing to real-time video consultations, expanding treatment beyond primary care.
Listen
Social Media Insights Shed Light on Patient Experiences With Uncomplicated UTIs
March 19th 2025To better understand patient experiences, the researchers analyzed qualitative and quantitative data from their social media posts about uncomplicated urinary tract infections (UTIs).
Read More
The Evolving Annual Wellness Visit
January 28th 2025The annual wellness visit is beneficial for patients, providers, and payers with an emphasis on preventive care for early intervention.
Listen
Trump Administration Cancels Crucial Funding for Diabetes Prevention Program
March 18th 2025Recent cuts to federal grants are set to have a widespread impact across numerous scientific and medical studies.
Read More
Widespread, Multifaceted Burden of CIDP Highlighted at MDA 2025
March 18th 2025Chronic inflammatory demyelinating polyneuropathy (CIPD) can have a substantial impact on patients everyday life and, consequently, put added stress on health care systems.
Read More
Disparities in Multiple Myeloma Distress Screenings May Point to Care Gaps
March 20th 2025Patients who did not complete a distress screener were also less likely to receive autologous stem cell transplants.
Read More
Telemedicine’s Evolution and Expanding Access to Obesity, Specialty Care
February 11th 2025George Jones of UpScript Health discusses telemedicine's evolution from basic e-prescribing to real-time video consultations, expanding treatment beyond primary care.
Listen
Social Media Insights Shed Light on Patient Experiences With Uncomplicated UTIs
March 19th 2025To better understand patient experiences, the researchers analyzed qualitative and quantitative data from their social media posts about uncomplicated urinary tract infections (UTIs).
Read More
The Evolving Annual Wellness Visit
January 28th 2025The annual wellness visit is beneficial for patients, providers, and payers with an emphasis on preventive care for early intervention.
Listen
Trump Administration Cancels Crucial Funding for Diabetes Prevention Program
March 18th 2025Recent cuts to federal grants are set to have a widespread impact across numerous scientific and medical studies.
Read More
Widespread, Multifaceted Burden of CIDP Highlighted at MDA 2025
March 18th 2025Chronic inflammatory demyelinating polyneuropathy (CIPD) can have a substantial impact on patients everyday life and, consequently, put added stress on health care systems.
Read More