"Highlights

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  Screening mammography reduces mortality, although adherence remains uneven

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  Education improves knowledge, trust, and mammography screening uptake in underserved groups

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  Culturally tailored programs and mobile units boost participation and access to screening

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  Patient navigation and culturally tailored programs are associated with improvements in screening mammography completion.

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  Digital literacy gaps risk widening disparities in future screening models

Abstract

Breast cancer remains a leading cause of cancer-related mortality among women in the United States. Although observational and randomized trial data have shown that screening mammography reduces mortality by up to 49% with consistent participation, adherence remains uneven, with persistent disparities driven by socioeconomic factors, insurance status, race and ethnicity, medical mistrust, and health literacy gaps. This narrative review examines inequities in access to breast cancer screening and synthesizes evidence on the impact of patient-centered educational interventions on screening uptake. Community-based outreach programs, radiology-integrated education initiatives, mobile mammography services, patient navigation models, and culturally tailored interventions consistently demonstrate improvements in screening knowledge, trust, and self-efficacy, particularly among underserved populations. Patient navigation services have been associated with a relative increase in screening rates of approximately 50% compared with control groups, and culturally tailored interventions, such as personalized brochures and bilingual workshops, have demonstrated meaningful absolute improvements in mammography completion. Community outreach and culturally responsive educational strategies are, therefore, not ancillary but central to the mission of breast imaging. Radiology practices have an imperative to lead these efforts, partnering with communities, integrating equitable risk assessment and navigation services, and ensuring that advances in technology translate into improved access and measurable gains in patient outcomes."