Purpose: There is scarce information on whether digital screening mammography performance differs between black and white women.
Methods: We examined 256,470 digital screening mammograms performed from 2005 to 2010 among 31,654 black and 133,152 white Carolina Mammography Registry participants aged ≥40 years. We compared recall rate, sensitivity, specificity, and positive predictive value (PPV1) between black and white women, adjusting for potential confounders using random effects logistic regression.
Results: Breast cancer was diagnosed in 276 black and 1,095 white women. Recall rates were similar for blacks and whites (8.6 vs. 8.5 %), as were sensitivity (83.7 vs. 82.4 %), specificity (91.8 vs. 91.9 %), and PPV1 (4.8 vs. 5.3 %) (all p values >0.05). Stratified and adjusted models showed similar results. Despite comparable mammography performance, tumors diagnosed in black women were more commonly poorly differentiated and hormone receptor negative.
Conclusion: Equivalent performance of digital screening mammography by race suggests that efforts to understand tumor disparities should focus on etiologic factors that influence tumor biology.
Keywords: Breast cancer; Disparities; Positive predictive value; Screening mammography; Sensitivity; Specificity.