Most breast imaging facilities in both high- and low-deprivation areas offer digital breast tomosynthesis
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New research has found that digital breast tomosynthesis (DBT) availability at breast imaging facilities is similar across low- and high-deprivation areas, but facilities in low-deprivation areas are significantly more likely to offer weekend appointments, which may affect access for traditionally underserved populations. The investigative team highlights that access can be influenced by service-time deserts in addition to traditional equipment deserts. The findings are published in the Journal of the American College of Radiology's (JACR) July issue.
"The widespread adoption of DBT across communities with varying socioeconomic characteristics is encouraging," said lead investigator Randy C. Miles, MD, MPH, associate professor of radiology at the University of Chicago and assistant editor with the JACR.
Miles and his colleagues set out to evaluate the association between ZIP code-level neighborhood deprivation and availability of DBT at FDA-accredited breast imaging facilities. According to the researchers, geographic availability alone is not sufficient to ensure equitable access to DBT services; complementary strategies such as cost-reduction policies and expanded scheduling are needed to improve DBT uptake in underserved populations.
Although the researchers found no difference in copayments and out-of-pocket expenses between low- and high-deprivation areas, they note that costs may disproportionately affect women from lower socioeconomic backgrounds, leading to lower utilization rates seen in prior studies.
"Addressing cost concerns and increasing access through patient-centered strategies, such as expanded online scheduling and weekend appointment availability, represent important next steps to improve DBT utilization across sociodemographic groups," Miles said.
"This impactful study identifies several barriers for women in high-deprivation areas seeking breast screening with DBT," said Ian A. Weissman, DO, FACR, a radiologist with the Milwaukee VAMC and past chair of the ACR Patient- and Family-Centered Care Outreach Committee.
"We found that lower-income patients are offered fewer weekend appointments, which can limit access to DBT, as they are less likely to receive paid sick leave. The cost of the breast screening exam, which is disproportionately higher for lower-income patients, also presents a financial barrier. Continuing to raise awareness of health disparities through meaningful research like this and advocating for patients through organizations like the Radiology Health Equity Coalition are critical to ensuring equal access to care for all patients."
Publication details
Cassie Deshong et al, Geographic Analysis of Digital Breast Tomosynthesis Availability in High- and Low-Deprivation Areas, Journal of the American College of Radiology (2026). DOI: 10.1016/j.jacr.2026.04.010
Journal information: Journal of the American College of Radiology
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