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Racial Differences in Screening Eligibility by Breast Density After State-Level Insurance Expansion

Mattia A. Mahmoud, MPhil, et al.

Aug 8, 2025

"Key Points

Question  How does eligibility for supplemental breast cancer screening based on breast density differ by race?

Findings  In this cross-sectional study of 68 478 Black and White women who underwent mammography, fewer Black women had extremely dense breasts or high lifetime breast cancer risk, making them less likely than White women to be eligible for insurance coverage of supplemental screening. The criteria for coverage identified fewer Black women with false-negative mammograms than White women.

Meaning  The findings of this study suggest that policies for insurance coverage of supplemental screening based on breast density may have limited ability to improve early detection for Black women."

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