Performance of digital screening mammography in a population-based cohort of black and white women

Cancer Causes Control. 2015 Oct;26(10):1495-9. doi: 10.1007/s10552-015-0631-3. Epub 2015 Jul 17.


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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Black or African American*
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / ethnology*
  • Breast Neoplasms / pathology
  • Early Detection of Cancer*
  • Female
  • Humans
  • Logistic Models
  • Mammography*
  • Middle Aged
  • Predictive Value of Tests
  • Registries
  • Sensitivity and Specificity
  • White People*