Summary: A study by the Harvey L. Neiman Health Policy Institute found that women, particularly those with dense breast tissue, face significantly longer travel distances to access breast MR or ultrasound facilities compared to mammography centers, with disparities in access varying by socioeconomic status and location.

Key Takeaways

  1. The study found that women needing supplemental breast cancer screening with MR or ultrasound face significantly longer travel distances, more than 2.7 times further, compared to accessing mammography centers.
  2. The research highlights disparities in access to breast imaging facilities, with individuals in socioeconomically disadvantaged or rural areas having to travel much farther for breast MR or ultrasound services than those in more advantaged or urban areas.
  3. The study suggests a need for improved access to breast MR or alternative imaging options to ensure early detection and better outcomes for women with dense breast tissue, who are at higher risk for breast cancer.

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A new Harvey L. Neiman Health Policy Institute study found the geographic distance to facilities providing breast MR or ultrasound was more than 2.7 times further than the distance to a mammography center. Given new breast density guidelines, now approximately one in two women (those who have dense breast tissue) are recommended to have supplemental breast cancer screening by breast MR or ultrasound due to their relatively higher breast cancer risk. 

Distance Gaps in Breast MR and Ultrasound Access

The research, published in the American Journal of Preventive Medicine, measured distance to the nearest facility offering mammography, breast MR and/or breast ultrasound for 29,629 ZIP codes. The researchers compared distance between imaging types to reveal the relative extent of this barrier to access and to inform approaches to mitigate disparities.

The study found that the mean distance to a provider offering breast MR was 23.2 miles compared with 8.2 miles to a mammography provider and 22.2 miles to a breast ultrasound provider. Hence, patients on average are only about one-third as far from the nearest location offering screening mammograms than from breast MR or ultrasound, which were comparably distant. The researchers also found that the distance to access supplemental screening was not equal for all Americans.

Socioeconomic Gaps in Breast Imaging Services

“Differences in distance to the nearest breast imaging facilities varied by the relative socioeconomic advantage of the community as well as across the spectrum from metropolitan to small/rural areas. We found that individuals living in the most socioeconomically disadvantaged ZIP codes were further from breast imaging facilities (12.2 miles for MR, 11.5 miles for ultrasound, and 2.4 miles for mammography) compared with individuals living in the most advantaged areas,” says Eric Christensen, PhD, research director at the Neiman Institute. 

“Similar MR-mammography access patterns existed regardless of the size of the city individuals lived in. For those in metropolitan areas, breast MR was twice as far as mammography, and for those in small/rural areas, breast MR was three times as far,” he says.

“Breast MR is now being recommended as an additional screening tool for the 50% of women with dense breasts. Having dense breast tissue is a risk factor for breast cancer and can reduce breast cancer detection by mammography alone. When breast MR is not available or contraindicated, breast ultrasound and/or contrast-enhanced mammography can be recommended as supplemental imaging techniques as well,” says Bhavika K. Patel, MD, vice chair of research at Mayo Clinic Arizona. “The results of our study indicate there either needs to be a way to reduce the differences in access to breast MR or avail all patients of effective alternatives to promote early detection and improve outcomes.”