"Abstract

Rationale and Objectives

To evaluate the timeliness of diagnostic evaluation after an abnormal screening mammogram in the years following the onset of the Coronavirus Disease 2019 (COVID-19) pandemic compared to the pre-pandemic year.

Materials and Methods

We retrospectively identified all patients recalled from screening mammography at our institution from January 1, 2019, to December 31, 2023. We assessed the rate of diagnostic evaluation at 30, 60 and 90 days following abnormal screening. We also evaluated the association between follow-up timeliness and sociodemographic characteristics.

Results

We identified a total of 15,814 screening mammograms with a BI-RADS 0 assessment during the study period. The mean age of the study cohort was 55.5 ± 12.0 years. The percentage of women who underwent diagnostic evaluation within 30 days of the abnormal screening mammogram persistently decreased from 88.8% in 2019 to 55.4% in 2022, then increased to 63.3% in 2023 (p < 0.001). Similar trends were observed in the rates of follow-up at 60 days and 90 days (p < 0.001). Age of 50–59 years (relative risk (RR): 1.25), being unemployed (RR: 1.18), single (RR: 1.27), of Asian/Pacific Islander (RR: 1.37) or Black race (RR: 1.69), or with neighborhood area deprivation index (ADI) in the highest quintile (RR=1.29) were significantly associated with higher risk of not following up within 90 days of an abnormal screening mammogram.

Conclusion

There have been persistent delays in diagnostic evaluation after an abnormal screening mammogram, with follow-up delays worsening during each year following the onset of the pandemic and certain subsets of women noted to be at higher risk for persistent, delayed follow-up. Evaluation of targeted interventions to provide support to subpopulations at higher risk for persistent, delayed follow-up may be beneficial."