The Challenges of Screening Mammography in Racial/Ethnic Minority Populations in the United States: A Mini-review and Observations from a Predominantly Hispanic Community

Screening mammography is recommended by U.S. medical organizations for breast cancer screening in average risk women because of its demonstrated reductions in breast cancer mortality. However, significant disparities in breast cancer screening utilization and mortality remain among racial/ethnic minorities. Efforts have appropriately been directed at increasing engagement with screening services in these populations, however, there is a dearth of data regarding false-positive rates and overdiagnosis in minority patients engaged in breast cancer screening. We recently examined screening practices among a predominantly Hispanic population presenting to an academic medical center in New York, NY, and found that approximately 53% of women experienced at least one false-positive mammography result over a median of 8.9 years of screening. We also observed that Hispanic women were more likely to screen annually than white women despite recommendations to screen less frequently. In this review, we briefly review the benefits and harms of screening mammography in average-risk women, namely, false-positive results and breast cancer overdiagnosis, followed by a discussion of the disparities in breast cancer screening and mortality among racial/ethnic minority populations. We then present our own recent observations and propose that future interventions among Hispanic and other minority populations could include patient- and provider-centered educational programs that focus on providing a balanced discussion of benefits and harms of screening mammography.