ASO Visual Abstract: Young Black Women May be More Likely to have First Mammogram Cancers-A New Perspective in Breast Cancer Disparities

Introduction: Black women are diagnosed with breast cancer at earlier ages and are 42% more likely to die from the disease than White women. Recommendations for commencement of screening mammography remain discordant. This study sought to determine the frequency of first mammogram cancers among Black women versus other self-reported racial groups. Methods: In this retrospective cohort study, clinical and mammographic data were obtained from 738 women aged 40–45 years who underwent treatment for breast cancer between 2010 and 2019 within a single hospital system. First mammogram cancers were defined as those with tissue diagnoses within 3 months of baseline mammogram. Multivariate logistic regression was applied to assess variables associated with first mammogram cancer detection. Results: Black women were significantly more likely to have first mammogram cancer diagnoses (39/82, 47.6%) compared with White women (162/610, 26.6%) and other groups (16/46, 34.8%) [p < 0.001]. Black women were also more likely to have a body mass index > 30 (p < 0.001), higher clinical T categories (p = 0.02), and present with more advanced clinical stages (p = 0.03). Every month delay in mammographic screening beyond age 40 years (odds ratio [OR] 1.06, 95% confidence interval [CI] 1.05–1.07; p < 0.0001), Black race (OR 2.24, 95% CI 1.10–4.53; p = 0.03), and lack of private insurance (OR 2.41, 95% CI 1.22–4.73; p = 0.01) were associated with an increased likelihood of cancer detection on first mammogram. Conclusion: Our findings suggests that Black women aged 40–45 years may be more likely to have cancer detected on their first mammogram and would benefit from starting screening mammography no later than age 40 years, and for those with elevated lifetime risk, even sooner. © 2023, Society of Surgical Oncology.