A team of Vanderbilt radiologists has published a manuscript in the Journal of Breast Imaging with recommendations for providing equitable breast care to an increasingly diverse population in the United States.
The first step in providing equitable care, says Katie Davis, DO, assistant professor of Radiology and Radiological Sciences, lead author of the manuscript, is educating current and incoming radiologists about breast health disparities. Specifically, racial and ethnic minorities, women from lower socioeconomic status, those living in rural areas, and the uninsured are affected disproportionately by breast cancer morbidity and mortality.
To exemplify this disparity, Davis highlights that non-Hispanic Black women are reported to have a higher breast cancer incidence rate under age 40, are at a higher risk of aggressive, triple-negative breast cancers, have a higher risk of pathogenic BRCA1 and BRCA2 mutations, and experience breast cancer mortality rates almost double that of non-Hispanic white women under age 50.
“While there is currently no centralized curriculum focusing on breast health disparities and inequities, by publishing this manuscript, we hope to reach a large audience of educators and trainees whose patients will benefit from the recommendations,” said Davis.
“Our field as a whole is starting to embrace health equity and the importance of addressing health disparities, and this manuscript can serve as a resource to institutions that are looking to teach their trainees about these issues,” said Lucy Spalluto, MD, MPH, associate professor of Radiology and vice chair of Health Equity in the department.
Another strategy for equitable breast health includes recruiting and retaining a more diverse population of radiology care providers. Davis and Spalluto believe this strategy will positively affect patient care by creating a sense of familiarity and trust between patients and doctors.
“When minority groups see doctors who look like them, it leads to a more trusting relationship and ultimately, better care,” Davis said. The manuscript also recommends formal education for care providers to ensure they are knowledgeable and culturally aware of the populations they serve.
The push for equitable breast imaging and care aligns with the Department of Radiology’s overall vision for diversity, inclusion and health equity in the field, with 60% of incoming residents in the department representing minority groups. But Davis and Spalluto believe all areas of medicine could greatly benefit from similar strategies.
“No one should be denied the ability to be healthy because they belong to a group that has historically been economically or socially disadvantaged,” Spalluto said. “With these recommendations in mind, hopefully the disparity gap in breast cancer outcomes will begin to narrow.”
“Our goal is to strive for the highest possible standard of health for all people, giving special attention to those at greatest risk for health disparities based on their social conditions,” Davis said. “We believe all specialties would be served by increasing their diversity and using a standardized curriculum to achieve the best health for their patients.”
